【摘要】 目的观察无创通气联合固尔苏（通用名:猪肺磷脂注射液）治疗新生儿呼吸窘迫综合征的效果及安全性。方法 63例新生儿呼吸窘迫综合征患儿,根据治疗方法不同分为对比组（22例）和研究组（41例）。对比组患儿采取有创通气联合固尔苏治疗,研究组患儿应用无创通气联合固尔苏治疗。比较两组患儿治疗前后血气指标（pH、血氧饱和度、动脉血氧分压、动脉血二氧化碳分压）、呼吸功能（氧合指数、肺动态比顺应性、吸气阻力）、氧疗时间、通气时间、住院时间以及并发症发生情况。结果治疗后,两组患儿pH、血氧饱和度、动脉血氧分压、动脉血二氧化碳分压、氧合指数、肺动态比顺应性、吸气阻力均较本组治疗前有所改善,且研究组患儿pH（7.44±0.14）、血氧饱和度（92.44±3.77）%、动脉血氧分压（84.81±6.99）mm Hg（1 mm Hg=0.133 kPa）、动脉血二氧化碳分压（37.18±3.22）mm Hg、氧合指数（348.85±24.11）mm Hg、肺动态比顺应性（41.18±3.35）ml/cm H₂O（1 cm H₂O=0.098 kPa）、吸气阻力（11.23±0.57）cm H₂O/（L·s）均优于对比组的（7.34±0.25）、（89.14±2.85）%、（78.64±6.78）mm Hg、（40.35±3.36）mm Hg、（322.77±23.45）mm Hg、（37.51±3.17）ml/cm H₂O、（11.78±0.58）cm H₂O/（L·s）,差异均具有统计学意义（P<0.05）。研究组氧疗时间（83.78±10.19）h、通气时间（52.33±13.16）h、住院时间（14.51±8.22）d均短于对比组的（94.32±12.55）h、（63.64±15.32）h、（19.77±10.69）d,差异均具有统计学意义（P<0.05）。研究组并发症发生率4.88%低于对比组的27.27%,差异具有统计学意义（P<0.05）。结论针对新生儿呼吸窘迫综合征患儿,可采取无创通气联合固尔苏进行治疗,能够显著改善患儿血气指标和呼吸功能,还可缩短治疗相关时间指标,降低相关并发症发生率。更多还原

【Abstract】 Objective To observe the effect and safety of noninvasive ventilator combined with poractant alfa injection（trade name: Curosurf） in the treatment of neonatal respiratory distress syndrome. Methods A total of 63 cases of neonatal respiratory distress syndrome were divided into control group（22 cases） and research group（41 cases）. The control group was treated by invasive ventilation combined with Curosurf, and the research group was treated by noninvasive ventilator combined with Curosurf. The blood gas indexes（pH, blood oxygen saturation, arterial oxygen partial pressure, arterial carbon dioxide partial pressure）, respiratory function（oxygenation index, dynamic lung compliance rate, inspiratory resistance） before and after treatment, time of oxygen therapy, ventilation time, hospitalization time and occurrence of complications were compared between the two groups. Results After treatment, pH, blood oxygen saturation, arterial oxygen partial pressure, arterial carbon dioxide partial pressure, oxygenation index, dynamic lung compliance rate, inspiratory resistance of the two groups were better than those before treatment of the same group. pH（7.44±0.14）, blood oxygen saturation（92.44±3.77）%, arterial oxygen partial pressure（84.81±6.99） mm Hg（1 mm Hg=0.133 kPa）, arterial carbon dioxide partial pressure（37.18±3.22） mm Hg, oxygenation index（348.85±24.11） mm Hg, dynamic lung compliance rate（41.18±3.35） ml/cm H₂O（1 cm H₂O=0.098 kPa） and inspiratory resistance（11.23±0.57）cm H₂O/（L·s） of the research group were all better than those of the control group（7.34±0.25）,（89.14±2.85）%,（78.64±6.78） mm Hg,（40.35±3.36） mm Hg,（322.77±23.45） mm Hg,（37.51±3.17） ml/cm H₂O and（11.78±0.58） cm H₂O/（L·s）, and the difference was statistically significant（P<0.05）. The time of oxygen therapy（83.78±10.19） h, ventilation time（52.33±13.16） h, hospitalization time（14.51±8.22） d of the research group were shorter than those of the control group（94.32±12.55） h,（63.64±15.32） h and（19.77±10.69） d, and the difference was statistically significant（P<0.05）. The occurrence of complications 4.88% of the research group was lower than that of the control group 27.27%, and the difference was statistically significant（P<0.05）. Conclusion For the treatment of neonatal respiratory distress syndrome, noninvasive ventilator combined with Curosurf can significantly improve the blood gas indexes and respiratory function, as well as shorten the treatment-related time indexes and reduce the incidence of related complications.更多还原