早产儿呼吸窘迫综合征机械通气下加用肺泡表面活性物质疗效观察

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目的 探讨早产儿呼吸窘迫综合征(RDS)简易持续正压(CPAP)机械通气下加用肺泡表面活性物质(PS)的效疗。方法 对2 1例早产儿呼吸窘迫综合征使用PS气管内滴入后观察呼吸频率、动脉血气、肺顺应性等变化。结果 与单纯机械通气相比,加用PS治疗后1h、6h呼吸频率由(70±8)次/min ,分别减慢至(6 2±5 )次/min及(5 4±6 )次/min(P <0 .0 1) ,PaO2 由(5 . 0 2±0 . 6 )kPa分别上升到(7. 8±1 0 )kPa及(0 . 0 8±1 0 .1)kPa(P <0 .0 1) ,PaCO2 由(8 .90±1 0 )kPa下降至(6 . 31±0 . 9)kPa及(5. 0 8±1 0 .1)kPa(P <0 .0 1) ,肺顺应性由(0 . 6±0 . 3) /kg ,分别上升达(0 . 8±0 . 4 ) /kg及(1 2±0 .4 ) /kg(P <0 . 0 1)。结论 早产儿RDS在机械通气时加用PS可有效改善通气换气功能,缩短人工通气时间,减少氧中毒,降低围生儿死亡率,增加健康存活率。 Objective To investigate the treatment of pulmonary surfactant (PS) in preterm infants with respiratory distress syndrome (RDS) under simple continuous positive pressure (CPAP) mechanical ventilation. Methods The changes of respiration rate, arterial blood gas and lung compliance were observed after intratracheal instillation of 21 cases of respiratory distress syndrome in preterm infants. Results Compared with simple mechanical ventilation, the respiratory rate decreased from (70 ± 8) times / min to (6 2 ± 5) times / min and (54 ± 6) times / min, (P <0.01), PaO2 increased from (5.2 ± 0.6) kPa to (7.8 ± 1 0) kPa and (0.08 ± 1.01) kPa (P <0. 01), PaCO2 decreased from (8 .90 ± 1 0) kPa to (6.31 ± 0.9) kPa and (5.80 ± 1.01) kPa (P <0.01) ), Lung compliance increased from (0.6 ± 0.3) / kg to (0.8 ± 0.4) / kg and (± 0.2 ± 0.4) / kg ). Conclusion Premature infants RDS plus mechanical ventilation PS can effectively improve the ventilatory function, shorten the artificial ventilation time, reduce oxygen poisoning, reduce perinatal mortality and increase the healthy survival rate.
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