CAJ | 학술논문

目的：观察肺表面活性物质（PS）联合持续正压通气(NCPAP)治疗新生儿肺透明膜病（NHMD）的疗效。方法选取100例NHMD患儿作为研究对象，将其随机分为观察组和对照组，每组各50例，观察组患者给予PS联合NCPAP治疗，对照组患者仅给予NCPAP治疗，对两组患儿治疗前后的动脉血气情况、呼吸机参数进行监测，并观察和比较在治疗期间发生肺炎的情况、氧疗时间、住院时间和费用、治愈率等情况。结果两组患儿治疗前的血氧分压(PaO2)、二氧化碳分压（PaCO2)差异无统计学意义(P>0.05)，治疗后各时间点观察组患儿的PaO2水平均显著高于对照组(P<0.05)，PaCO2水平均显著低于对照组(P<0.05)；两组患儿进行NCPAP治疗时的氧浓度分数(FiO2)、呼气末正压（PEEP）初设值差异无统计学意义(P>0.05)，在治疗后各时点观察组的FiO2和PEEP均显著低于对照组(P<0.05)；两组患儿发生肺炎的比例分别为30.0%和74.0%，观察组显著低于对照组(P<0.05)，观察组的氧疗时间和住院时间显著低于对照组(P<0.05)，两组患者住院费用差异无统计学意义(P>0.05)，两组的治愈率分别为82.0%和58.0%，观察组显著高于对照组(P<0.05)。结论应用PS联合NCPAP治疗NHMD可显著且较快地改善患者血气指标，有利于患儿早日撤离呼吸机，并可减少治疗期间肺炎的发生，缩短住院时间，和氧疗时间、提高治愈率，而且不会使治疗费用显著增加。
목적：관찰폐표면활성물질（PS）연합지속정압통기(NCPAP)치료신생인폐투명막병（NHMD）적료효。방법선취100례NHMD환인작위연구대상，장기수궤분위관찰조화대조조，매조각50례，관찰조환자급여PS연합NCPAP치료，대조조환자부급여NCPAP치료，대량조환인치료전후적동맥혈기정황、호흡궤삼수진행감측，병관찰화비교재치료기간발생폐염적정황、양료시간、주원시간화비용、치유솔등정황。결과량조환인치료전적혈양분압(PaO2)、이양화탄분압（PaCO2)차이무통계학의의(P>0.05)，치료후각시간점관찰조환인적PaO2수평균현저고우대조조(P<0.05)，PaCO2수평균현저저우대조조(P<0.05)；량조환인진행NCPAP치료시적양농도분수(FiO2)、호기말정압（PEEP）초설치차이무통계학의의(P>0.05)，재치료후각시점관찰조적FiO2화PEEP균현저저우대조조(P<0.05)；량조환인발생폐염적비례분별위30.0%화74.0%，관찰조현저저우대조조(P<0.05)，관찰조적양료시간화주원시간현저저우대조조(P<0.05)，량조환자주원비용차이무통계학의의(P>0.05)，량조적치유솔분별위82.0%화58.0%，관찰조현저고우대조조(P<0.05)。결론응용PS연합NCPAP치료NHMD가현저차교쾌지개선환자혈기지표，유리우환인조일철리호흡궤，병가감소치료기간폐염적발생，축단주원시간，화양료시간、제고치유솔，이차불회사치료비용현저증가。
Objective To observe the curative effects of pulmonary surfactant (PS) combined with nasal continuous positive airway pressure (NCPAP) in treatment of the patients with neonatal hyaline membrane disease (NHMD). Methods One hundred cases of children with NHMD were selected as research objects and randomly divid-ed into observation group and control group, with 50 cases in each one. The patients in the observation group were treat-ed with PS combined with NCPAP therapy, while the patients in the control group were treated with NCPAP treatment. The arterial blood gas condition, respiratory parameters of the patients in the two groups before and after treatment were monitored. The incidence of pneumonia during the treatment, the oxygen therapy duration, the hospitalization time and cost, the cure rates of the patients were observed and compared. Results There were no significant differences in the partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) between the two groups before the treatment (P>0.05). The PaO2 of the patients in the observation group was significantly higher than that in the control group and the PaCO2 of the patients in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in the fraction of inspiration O2 (FiO2), positive end-expiratory pressure (PEEP) during the NCPAP treatment between the two groups. But after treatment, the FiO2 and PEEP values of the pa-tients in the observation group were significantly lower than those in the control group (P<0.05). The incidences of pneumonia in the two groups were 30%and 74%respectively, which was lower in the observation group (P<0.05). The oxygen therapy duration and the hospitalization time in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the hospitalization expense between the two groups (P>0.05). The cure rates of the observation group was significantly higher than that in the control group (82%vs 58%, P<0.05). Conclusion The application of PS combined with NCPAP in the treatment of NHMD can improve the indexes of blood gas analysis quickly, help the early withdrawal of ventilation, reduce the occurrence of pneumonia during treatment, shorten hospitalization time and the oxygen therapy duration, and improve the cure rate, with no increasing in the cost.