中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2012年
2期
152-155
,共4页
王娜%张立明%张爱梅%石雁%尹延娥
王娜%張立明%張愛梅%石雁%尹延娥
왕나%장립명%장애매%석안%윤연아
早产儿%呼吸窘迫综合征%持续气道正压通气%氨溴索%预防%治疗
早產兒%呼吸窘迫綜閤徵%持續氣道正壓通氣%氨溴索%預防%治療
조산인%호흡군박종합정%지속기도정압통기%안추색%예방%치료
premature infant%respiratory distress syndrome%continuous positive airway pressure%ambrogol%prevention%treatmennt
目的 探讨早期应用气流驱动式(IFD)气泡式鼻塞持续气道iF压通气(BNCPAP)联合大剂量氨溴索防治早产儿呼吸窘迫综合征(NRDS)的疗效.方法 选取2009年10月至2011年9月于本院产科分娩后30 min内转入本科的79例早产儿为研究对象,并按照转入顺序随机分为治疗组(IFD-BNCPAP+大剂量氨溴索,n=42)及对照组(常规治疗,n=37).观察两组患儿生命体征、NRDS发生率、机械通气(MV)使用率、通气时间,住院时间、MV治疗前及12h后血气分析、呼吸指数(RI)及氧合指数(OJ)、肺动态顺应性(Crs)、呼吸道阻力(R)、压力容量(P-V)曲线斜率及并发症发生率,并对结果进行统计学分析(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书).结果 两组患儿NRDS发生率和MV使用率比较,差异有统计学意义(P＜0.05).治疗组通气时间及住院时间较对照组明显减少,差异有统计学意义(P＜0.05).两组MV治疗前及12 h后二氧化碳分压(PaCC2)、OI及RI比较,差异有统计学意义(P＜0.01),pH值比较,差异无统计学意义(P＞0.05);两组上机24 h及72 h后,Crs,R及P-V曲线斜率比较,差异有统计学意义(P＜0.01).治疗组并发症发生率低于对照组,但差异无统计学意义(P＞0.05).结论 早期应用IFD-BNCPAP联合大剂量氨溴索可提高肺顺应性,改善肺氧合功能,对NRDS具有良好疗效.
目的 探討早期應用氣流驅動式(IFD)氣泡式鼻塞持續氣道iF壓通氣(BNCPAP)聯閤大劑量氨溴索防治早產兒呼吸窘迫綜閤徵(NRDS)的療效.方法 選取2009年10月至2011年9月于本院產科分娩後30 min內轉入本科的79例早產兒為研究對象,併按照轉入順序隨機分為治療組(IFD-BNCPAP+大劑量氨溴索,n=42)及對照組(常規治療,n=37).觀察兩組患兒生命體徵、NRDS髮生率、機械通氣(MV)使用率、通氣時間,住院時間、MV治療前及12h後血氣分析、呼吸指數(RI)及氧閤指數(OJ)、肺動態順應性(Crs)、呼吸道阻力(R)、壓力容量(P-V)麯線斜率及併髮癥髮生率,併對結果進行統計學分析(本研究遵循的程序符閤本院人體試驗委員會所製定的倫理學標準,得到該委員會批準,分組徵得受試對象鑑護人的知情同意,併與之籤署臨床研究知情同意書).結果 兩組患兒NRDS髮生率和MV使用率比較,差異有統計學意義(P＜0.05).治療組通氣時間及住院時間較對照組明顯減少,差異有統計學意義(P＜0.05).兩組MV治療前及12 h後二氧化碳分壓(PaCC2)、OI及RI比較,差異有統計學意義(P＜0.01),pH值比較,差異無統計學意義(P＞0.05);兩組上機24 h及72 h後,Crs,R及P-V麯線斜率比較,差異有統計學意義(P＜0.01).治療組併髮癥髮生率低于對照組,但差異無統計學意義(P＞0.05).結論 早期應用IFD-BNCPAP聯閤大劑量氨溴索可提高肺順應性,改善肺氧閤功能,對NRDS具有良好療效.
목적 탐토조기응용기류구동식(IFD)기포식비새지속기도iF압통기(BNCPAP)연합대제량안추색방치조산인호흡군박종합정(NRDS)적료효.방법 선취2009년10월지2011년9월우본원산과분면후30 min내전입본과적79례조산인위연구대상,병안조전입순서수궤분위치료조(IFD-BNCPAP+대제량안추색,n=42)급대조조(상규치료,n=37).관찰량조환인생명체정、NRDS발생솔、궤계통기(MV)사용솔、통기시간,주원시간、MV치료전급12h후혈기분석、호흡지수(RI)급양합지수(OJ)、폐동태순응성(Crs)、호흡도조력(R)、압력용량(P-V)곡선사솔급병발증발생솔,병대결과진행통계학분석(본연구준순적정서부합본원인체시험위원회소제정적윤리학표준,득도해위원회비준,분조정득수시대상감호인적지정동의,병여지첨서림상연구지정동의서).결과 량조환인NRDS발생솔화MV사용솔비교,차이유통계학의의(P＜0.05).치료조통기시간급주원시간교대조조명현감소,차이유통계학의의(P＜0.05).량조MV치료전급12 h후이양화탄분압(PaCC2)、OI급RI비교,차이유통계학의의(P＜0.01),pH치비교,차이무통계학의의(P＞0.05);량조상궤24 h급72 h후,Crs,R급P-V곡선사솔비교,차이유통계학의의(P＜0.01).치료조병발증발생솔저우대조조,단차이무통계학의의(P＞0.05).결론 조기응용IFD-BNCPAP연합대제량안추색가제고폐순응성,개선폐양합공능,대NRDS구유량호료효.
Objective To evaluate the effect of infant flow driver bubble nasal continuous positive airway pressure (IFD-BNCPAP) combined with large dose ambroxol in the prevention and treatment on neonatal respiratory distress syndrome (NRDS).Methods From October 2009 to September 2011,79 premature infants who were born within 30 min and sent in department of neonatology were included in the study,and were divided randomly into treatment group(IFDBNCPAP+ambroxol,n=42) and control group (regular treatment,n=37).The vital sign,incidence rate of NRDS,usage rate of mechanical ventilation (MV),duration of ventilation and hospitalization,blood gas analysis results,respiratory index (RI),respiratory compliance(Crs),resistance(R) and pressure-volume curve (P-V) slope of curve were observed and statistically analyzed.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Hospital of Weifang Medical University.Informed consent was obtained from each parents.Results There were significant differences in incidence rate of NRDS and usage rate of MV between two groups(P＜0.05).The duration of ventilation and hospitalization in treatment group was obviously lower than those in control group(P＜0.05).The blood gas analysis results showed that there had significant difference in PaCO2,RI,Crs,R and P-V slope of curve between two groups(P＜0.05).There was no significant difference in incidence rate of complication between two groups( P＞ 0.05).Conclusions The IFD-BNCPAP combined with large dose ambroxol on premature infants with NRDS had great effect in early time.This method can effectively improve oxygenation function,meanwhile can prevent and treat NRDS.
