CAJ | 학술논문

目的：通过对比不同时段应用肺表面活性物质( PS,商品名：固尔苏)联合经鼻持续气道正压通气(NCPAP)治疗胎龄≤32周新生儿呼吸窘迫综合征(NRDS)的疗效差异。方法：将2011年5月~2013年4月高州市人民医院新生儿科收治的胎龄≤32周、确诊为NRDS的67例早产儿,按照PS的给予时间不同进行分组,观察组31例为在本院产科出生的早产儿,出生后1 h内在本院产房或手术室内给药；对照组36例为出生后6 h内由外院转诊我院新生儿科的早产儿,转至新生儿病房后即在新生儿病房内给药。两组患儿给药后均接NCPAP辅助呼吸,比较两组患儿用药后的临床症状、胸片、动脉血气等的变化程度,以及NCPAP辅助通气时间、上机率、病死率、并发症等方面的差异。结果：观察组临床症状、胸片及动脉血气得到较快改善,与对照组差异有统计学意义；观察组NCPAP辅助通气时间相对较短,上机率少,但差异无统计学意义；两组患儿病死率及并发症的发生率差异无统计学意义。结论：产房或手术室内极早期应用固尔苏可明显改善患儿呼吸功能,为NRDS患儿的后续治疗提供有利前提。
목적：통과대비불동시단응용폐표면활성물질( PS,상품명：고이소)연합경비지속기도정압통기(NCPAP)치료태령≤32주신생인호흡군박종합정(NRDS)적료효차이。방법：장2011년5월~2013년4월고주시인민의원신생인과수치적태령≤32주、학진위NRDS적67례조산인,안조PS적급여시간불동진행분조,관찰조31례위재본원산과출생적조산인,출생후1 h내재본원산방혹수술실내급약；대조조36례위출생후6 h내유외원전진아원신생인과적조산인,전지신생인병방후즉재신생인병방내급약。량조환인급약후균접NCPAP보조호흡,비교량조환인용약후적림상증상、흉편、동맥혈기등적변화정도,이급NCPAP보조통기시간、상궤솔、병사솔、병발증등방면적차이。결과：관찰조림상증상、흉편급동맥혈기득도교쾌개선,여대조조차이유통계학의의；관찰조NCPAP보조통기시간상대교단,상궤솔소,단차이무통계학의의；량조환인병사솔급병발증적발생솔차이무통계학의의。결론：산방혹수술실내겁조기응용고이소가명현개선환인호흡공능,위NRDS환인적후속치료제공유리전제。
Objective:To compare the differences in the efficacy of pulmonary surfactant ( PS ) in combination with nasal continuous positive airway pressure ( NCPAP ) , when administered at different time points, on neonatal respiratory distress syndrome ( NRDS) in neonates aged 32 weeks or less. Methods:Between May 2011 and April 2013, we recruited 67 neonates with NRDS aged 32 weeks or less, from the department of neonatology, Gaozhou People ' s Hospital. Neonates were assigned according to the time of PS administration. Observation group ( n=31) received PS within the first hour after birth in the delivery rooms or operating rooms. Control group ( n=36) received PS in 1 6 h after birth in the neonatal ward, after referral from other hospitals. NCPAP was implemented after the administration of PS. The changes in clinical manifestation, arterial blood gas, chest X ray with time, the duration of NCPAP and the rates of mechanical ventilation and mortality and complications were compared. Results: The clinical manifestation, arterial blood gas and chest X ray were rapidly improved in the observation group compared with the control group ( all P<0.05) . The observation group was associated with a numerically but not statistically shorter duration of NCPAP, a lower rate of mechanical ventilation compared with control group (both P>0.05). The between group differences in mortality rate and complications were unremarkable (both P>0.05).Conclusion: The early administration of PS in the delivery rooms or operating rooms markedly improves the respiratory function and confers promising outcomes for the subsequent treatment of NRDS.