标题：非侵入性呼吸支持治疗新生儿呼吸窘迫综合征临床观察

      作者：田鸾英，陈 俊
    （深圳市南山区妇幼保健院新生儿科，广东 深圳 518052）

      卷次： 2014年25卷13期

      【摘要】 目的 观察非侵入性呼吸支持对新生儿呼吸窘迫综合征的临床疗效。方法 将胎龄≤35周，且符
合新生儿呼吸窘迫综合征(NRDS)诊断标准的82例早产儿作为观察对象。尽早给予NCPAP支持，若失败则改用
NIPPV支持，必要时使用PS或机械通气。结果 82例观察对象全部使用了NCPAP，其中19例因效果不明显改
用了NIPPV，66例使用了PS；72 h内无一例使用有创机械通气，但有4例患儿后期因合并院内感染或BPD使用了
气管插管机械通气；82例中1例因先天性肠闭锁于生后第二天转外科手术治疗，1例因经济原因于第2天签字出
院，其余 80例均痊愈出院。结论 无创呼吸支持用于治疗早产儿NRDS疗效肯定，部分患儿如果尽早使用
NCPAP或NIPPV，可以不使用PS。因无创呼吸支持经济便捷，值得临床推广应用。

      【关键词】 呼吸窘迫综合征；早产儿；鼻塞持续气道正压给氧；经鼻间歇正压通气；肺表面活性物质

      【中图分类号】 R722.12 【文献标识码】 A 【文章编号】 1003—6350（2014）13—1988—03


Noninvasive respiratory support for preterm infants with respiratory distress syndrome.
TIAN Luan-ying,
CHEN Jun. Department of Neonatology, Nanshan Maternity & Child Healthcare Hospital of Shenzhen, Shenzhen 518052,
Guangdong, CHINA.

【Abstract】 Objective To evaluate the efficacy and safety of noninvasive respiratory support for preterm in-
fants with respiratory distress syndrome. Methods Chart data of inborn infants≤35 weeks with respiratory distress
syndrome (RDS) in the period 1st Aug 2011 to 31st July 2013 were reviewed. Nasal continuous positive airway pressure
(NCPAP) was given as early as possible when RDS was suspected, while nasal intermittent positive pressure ventila-
tion (NIPPV) was given to those failed NCPAP. Mechanical ventilation (MV) or surfactant would be given as neces-
sary. Results Eighty-two preterm infants were enrolled, all of which received NCPAP in 72 hours of age, and nine-
teen received NIPPV due to failure of CPAP. No infants needed MV in their first 72 hours of life, but 4 infants needed
in the later due to nosocomial infection or bronchopulmonary dysplasia (BPD). Eighty of 82 infants recovered except
one transferred to surgery departmemt due to intestinal atresia and another one gave up due to economical reason.
Conclusion Noninvasive respiratory support is successful and safe for preterm infants with respiratory distress syn-
drome, and NIPPV is more effective than NCPAP. And the earlier the use, the better the outcome.

      【Key words】 Respiratory distress syndrome; Preterm infant; Nasal continuous positive airway pressure
(CPAP); Nasal intermittent positive pressure ventilation (NIPPV); Pulmonary surfactant
·临床经验·doi:10.3969/j.issn.1003-6350.2014.13.0771