新生儿肺透明膜病36例临床分析及治疗探讨

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[目的]探讨肺表面活性物质(固尔苏)、鼻塞持续气道正压通气(N-CPAP)、静脉注射沐舒坦治疗早产儿肺透明膜病(HMD)的疗效。[方法]将36例确诊为新生儿肺透明膜病的早产儿资料进行回顾性对比分析:其中14例给予固尔苏治疗的列为Ⅰ组,8例使用鼻塞持续气道正压通气(N-CPAP)的列为Ⅱ组,14例予静脉注射沐舒坦治疗的列为Ⅲ组。[结果]将3组患儿治疗前及治疗后皮肤颜色,经皮血氧饱和度以及症状、体征变化,N-CPAP时间,平均住院天数进行比较:Ⅰ组改善缺氧症状最迅速,NCPAP给氧时间及住院时间最短,Ⅱ组次之,Ⅲ组最差。3组比较差异有统计学意义(P﹤0.001)。Ⅰ组14例中12例治愈,2例死亡,治愈率为86%。Ⅱ组8例中6例治愈,1例自动出院,1例死亡,治愈率为75%。Ⅲ组14例中7例治愈,1例自动出院,6例死亡,治愈率为50%。[结论]肺表面活性物质治疗能快速、安全、有效地改善肺透明膜病早产患儿的肺功能及临床症状,提高了患儿的抢救成活率,且缩短了早产儿吸氧时间,减少了早产儿视网膜病变的发生。N-CPAP以其安全、舒适、方便、价廉又重新用于临床。 [Objective] To investigate the efficacy of pulmonary surfactant (Curetos), nasal continuous positive airway pressure (N-CPAP) and intravenous mucosolvan in the treatment of hyaline membrane disease (HMD) in preterm infants. [Methods] The data of 36 preterm infants diagnosed as neonatal hyaline membrane disease were retrospectively analyzed. Among them, 14 cases were given glucocorticolate as group Ⅰ, and 8 cases were treated with nasal continuous positive airway pressure (N -CPAP) as a group Ⅱ, 14 cases of intravenous mucosolvan treatment as a group Ⅲ. [Results] The skin color, percutaneous oxygen saturation, symptoms and signs, N-CPAP time and average length of stay before and after treatment in three groups of children were compared: the first group to improve the symptoms of hypoxia most rapidly, NCPAP Oxygen time and hospitalization time were the shortest, followed by group Ⅱ, and group Ⅲ was the worst. The difference between the three groups was statistically significant (P <0.001). Among 14 cases in group Ⅰ, 12 cases were cured and 2 cases died. The cure rate was 86%. In group Ⅱ, 6 cases were cured in 8 cases, 1 case was discharged automatically and 1 case died. The cure rate was 75%. Among 14 cases in group Ⅲ, 7 were cured, 1 were discharged automatically, and 6 died. The cure rate was 50%. [Conclusion] Pulmonary surfactant treatment can improve pulmonary function and clinical symptoms in children with premature delivery of hyaline membrane disease quickly, safely and effectively, improve survival rate of children with salvage, and shorten oxygen inhalation time in preterm infants, reduce Occurrence of retinopathy of prematurity. N-CPAP for its safety, comfort, convenience, cheap and re-used in clinical.
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