CAJ | 학술논문

目的探讨新生儿肺透明膜病(HMD)呼吸支持治疗的综合诊治,总结并提出新生儿肺透明膜病的呼吸支持治疗的预后措施.方法对本院近2年接收的52例新生儿肺透明膜病的临床诊治进行回顾性分析,把患儿分为固尔苏治疗组和未使用固尔苏治疗两组.52例患儿均进行了对症呼吸支持治疗,供氧治疗,在治疗过程中根据患儿的血氧饱和度、血气检查进行氧气的供给调整.52例患儿中12例进行头罩吸氧,13例患儿进行鼻塞式持续正压通气(CPAP),9例因患儿病情严重无法改善,采用机械通气治疗;7例患儿 X 线片胸部为Ⅲ、Ⅳ级均直接进行了机械通气治疗,11例患儿应用肺泡表面活性药物(PS)固尔苏进行治疗.结果52例新生儿肺透明膜病中治疗痊愈的有31例(78.00%),2例患儿因病情严重恶化放弃治疗(5.66%),7例治疗过程中死亡(16.67%).使用固尔苏治疗的患儿组病死率明显低于未使用固尔苏治疗治疗组(P <0.05),患儿辅助机械通气时间显着缩短(t=2.4252,P <0.01);诊断胸片为Ⅲ、Ⅳ级的改变者较胸片改为Ⅰ、Ⅱ级的机械通气时间长(t=3.7630;P <0.01),病死率高(P <0.01).结论新生儿肺透明膜治病病死率高,应加强孕妇围产期保健;应该肺泡活性药物固尔苏(PS)能有效改善肺透明膜的预后;新生儿体质量大于1800g,胸片改变为Ⅰ、Ⅱ级的新生儿肺透明膜临床诊治综合预后较好,Ⅲ、Ⅳ级预后差.
목적탐토신생인폐투명막병(HMD)호흡지지치료적종합진치,총결병제출신생인폐투명막병적호흡지지치료적예후조시.방법대본원근2년접수적52례신생인폐투명막병적림상진치진행회고성분석,파환인분위고이소치료조화미사용고이소치료량조.52례환인균진행료대증호흡지지치료,공양치료,재치료과정중근거환인적혈양포화도、혈기검사진행양기적공급조정.52례환인중12례진행두조흡양,13례환인진행비새식지속정압통기(CPAP),9례인환인병정엄중무법개선,채용궤계통기치료;7례환인 X 선편흉부위Ⅲ、Ⅳ급균직접진행료궤계통기치료,11례환인응용폐포표면활성약물(PS)고이소진행치료.결과52례신생인폐투명막병중치료전유적유31례(78.00%),2례환인인병정엄중악화방기치료(5.66%),7례치료과정중사망(16.67%).사용고이소치료적환인조병사솔명현저우미사용고이소치료치료조(P <0.05),환인보조궤계통기시간현착축단(t=2.4252,P <0.01);진단흉편위Ⅲ、Ⅳ급적개변자교흉편개위Ⅰ、Ⅱ급적궤계통기시간장(t=3.7630;P <0.01),병사솔고(P <0.01).결론신생인폐투명막치병병사솔고,응가강잉부위산기보건;응해폐포활성약물고이소(PS)능유효개선폐투명막적예후;신생인체질량대우1800g,흉편개변위Ⅰ、Ⅱ급적신생인폐투명막림상진치종합예후교호,Ⅲ、Ⅳ급예후차.
Objective Explored the comprehensive diagnosis and treatment of hyaline membrane disease(HMD) respiratory support treatment,summarized the neonatal measures of HMD respiratory support treatment. Methods Retrospectively analyzed 52 cases with HMD in our hospital for nearly 2 years, divided into the Curosurf group and no use Curosurf group.all 52 cases with symptomatic respiratory support treatment, oxygen treatment,during treatment of children with oxygen saturation, blood gas to check the oxygen supply. Results Cured in 52 cases of HMD in 31 cases(78.00%),2 cases with serious deterioration so gave up treatment(5.66%),7 cases during the treatment died(16.67%). Curosurf children mortality rate was significantly lower than the unused Curosurf treatment group (P<0.05), children assisted mechanical ventilation time was significantly shortened (t = 2.4252, P <0.01); diagnostic chest X-rayfor Ⅲ of grade Ⅳ change compared to chest X-ray instead Ⅰ class II mechanical ventilation time (t = 3.7630; P <0.01), and high mortality (P <0.01).Conclusion HMD had high mortality,should strengthen the perinatal care of pregnant women; alveolar active drug Curosurf(PS)can effectively improve the prognosis of HMD;birth weight than 1800g, HMD chest X-ray changed in grade I、II had a good clinical diagnosis and treatment prognosis,grade III、IV was poor.