中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
7期
768-770
,共3页
足月%新生儿%急性呼吸窘迫综合征
足月%新生兒%急性呼吸窘迫綜閤徵
족월%신생인%급성호흡군박종합정
Full-term%Newborn%Acute respiratory distress syndrome
目的 分析足月新生儿急性呼吸窘迫综合征的发病原因,探索其治疗的方法,分析肺表面活性剂的作用.方法 将所有的足月新生儿急性呼吸窘迫综合征患儿62例分成A(50例)、B组(12例)2组,B组在A组的治疗途径上另加肺表面活性物质进行治疗,并对2组各指标进行分析比较.分析指标包括:pH、PaO2、PaCO2、SaO2、HCO3.结果 新生儿窒息42例(68%);窒息合并吸入性肺炎36例(58%),剖宫产19例(31%),奶汁吸入性肺炎6例(10%),感染性肺炎3例(5%),ROC曲线显示曲线下面积分别为0.80、0.76、0.35、0.83、0.74,新生儿窒息,窒息合并吸入性肺炎,奶汁吸入性肺炎以及感染性肺炎和足月新生儿急性呼吸窘迫综合征具有相关性.A、B组的PaO2分别为(78.80±8.23)mm Hg和(87.20 ±8.30)mm Hg(t=4.56,P<0.05);SaO2分别为(89.50±5.40)%和(99.63±3.30)%(t=5.78,P<0.05);差异均有统计学意义.B组的治愈率为92%,A组的治愈率为80%(x2=3.5,P<0.05).结论 足月新生儿出现急性呼吸窘迫综合征的原因很多,指征宜放宽,并以临床严密观察和连续监测血氧饱和度为依据是行之有效的方法.肺表面活性剂对于治疗足月新生儿急性呼吸窘迫综合征疗效较好.
目的 分析足月新生兒急性呼吸窘迫綜閤徵的髮病原因,探索其治療的方法,分析肺錶麵活性劑的作用.方法 將所有的足月新生兒急性呼吸窘迫綜閤徵患兒62例分成A(50例)、B組(12例)2組,B組在A組的治療途徑上另加肺錶麵活性物質進行治療,併對2組各指標進行分析比較.分析指標包括:pH、PaO2、PaCO2、SaO2、HCO3.結果 新生兒窒息42例(68%);窒息閤併吸入性肺炎36例(58%),剖宮產19例(31%),奶汁吸入性肺炎6例(10%),感染性肺炎3例(5%),ROC麯線顯示麯線下麵積分彆為0.80、0.76、0.35、0.83、0.74,新生兒窒息,窒息閤併吸入性肺炎,奶汁吸入性肺炎以及感染性肺炎和足月新生兒急性呼吸窘迫綜閤徵具有相關性.A、B組的PaO2分彆為(78.80±8.23)mm Hg和(87.20 ±8.30)mm Hg(t=4.56,P<0.05);SaO2分彆為(89.50±5.40)%和(99.63±3.30)%(t=5.78,P<0.05);差異均有統計學意義.B組的治愈率為92%,A組的治愈率為80%(x2=3.5,P<0.05).結論 足月新生兒齣現急性呼吸窘迫綜閤徵的原因很多,指徵宜放寬,併以臨床嚴密觀察和連續鑑測血氧飽和度為依據是行之有效的方法.肺錶麵活性劑對于治療足月新生兒急性呼吸窘迫綜閤徵療效較好.
목적 분석족월신생인급성호흡군박종합정적발병원인,탐색기치료적방법,분석폐표면활성제적작용.방법 장소유적족월신생인급성호흡군박종합정환인62례분성A(50례)、B조(12례)2조,B조재A조적치료도경상령가폐표면활성물질진행치료,병대2조각지표진행분석비교.분석지표포괄:pH、PaO2、PaCO2、SaO2、HCO3.결과 신생인질식42례(68%);질식합병흡입성폐염36례(58%),부궁산19례(31%),내즙흡입성폐염6례(10%),감염성폐염3례(5%),ROC곡선현시곡선하면적분별위0.80、0.76、0.35、0.83、0.74,신생인질식,질식합병흡입성폐염,내즙흡입성폐염이급감염성폐염화족월신생인급성호흡군박종합정구유상관성.A、B조적PaO2분별위(78.80±8.23)mm Hg화(87.20 ±8.30)mm Hg(t=4.56,P<0.05);SaO2분별위(89.50±5.40)%화(99.63±3.30)%(t=5.78,P<0.05);차이균유통계학의의.B조적치유솔위92%,A조적치유솔위80%(x2=3.5,P<0.05).결론 족월신생인출현급성호흡군박종합정적원인흔다,지정의방관,병이림상엄밀관찰화련속감측혈양포화도위의거시행지유효적방법.폐표면활성제대우치료족월신생인급성호흡군박종합정료효교호.
Objective To explore the pathogenesis of acute respiratory distress syndrome (ARDS) in fullterm newborns, and to assess the effect of pulmonary surfactant. Methods All full-term newboms were divided into two groups,with 50 cases in group A and 12 cases in group B. Compared to the treatment of group A,pulmonary surfactant was added to group B. The indicators of pH, PaO2, PaCO2, SaO2, HCO3- were compared between the two groups.Results The cure rate was 92% in group B , which was significant higher than that of 80% in group A( t = 3. 5,P < 0. 05 ). There were 42 cases of neonatal asphyxia (68%), 36 cases of asphyxia combined aspiration pneumonia (58% ) ,19 cases of cesarean section(31% ) ,6 cases of milk aspiration pneumonia (10% ) and 3 cases of infectious pneumonia (5 % ). The AUC was 0. 80,0. 76,0. 35,0. 83 and 0.74, respectively.Neonatal asphyxia, asphyxia combined aspiration pneumonia,milk aspiration pneumonia and infectious pneumonia were associated with ARDS in full-term newborns. PaO2 in group A and B was (78. 80 ± 8. 2 ) mm Hg and (87. 20 ± 8. 30) mm Hg, respectively (t = 4. 56, P < 0. 05 ). SaO2 in group A was (89. 50 ± 5.40) % ,which was significantly lower than that of (99. 63 ± 3. 30 ) % in group B (t = 5. 78, P < 0. 05). Conclusions There are various causes of ARDS in full-term newborns.Intensive clinical observation and continuous monitoring of blood oxygen saturation will be helpful to improve the efficiency of treatment Pulmonary surfactants can improve the efficiency in the treatment of ARDS in the full-term newboms.
