标题：肺表面活性物质联合鼻塞式持续正压通气治疗新生儿肺透明膜病疗效观察

      作者：王子谦
    (宜宾市第二人民医院儿科，四川 宜宾 644000)

      卷次： 2014年25卷14期

      【摘要】 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。

      【关键词】 肺表面活性物质；鼻塞式持续正压通气；新生儿肺透明膜病；疗效

      【中图分类号】 R722.12 【文献标识码】 A 【文章编号】 1003—6350（2014）14—2066—04


Observation on the curative effects of pulmonary surfactant combined with nasal continuous positive airway
pressure in treatment of the patients with neonatal hyaline membrane disease.
WANG Zi-qian. Department of
Paediatrics, the Second People's Hospital of Yibin, Yibin 644000, Sichuan, CHINA

【Abstract】 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.

      【Key words】 Pulmonary surfactant; Nasal continuous positive airway pressure ventilation; Neonatal hyaline
membrane disease; Curative effect