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| 肺表面活性物质治疗新生儿呼吸窘迫综合征前给予nCPAP呼吸支持最佳时间窗的临床研究 |
| Clinical Study on the Optimal Time Window of nCPAP Respiratory Support Before Pulmonary Surfactant Treatment for Neonatal Respiratory Distress Syndrome |
| 投稿时间：2022-11-22 修订日期：2022-11-22 |
| DOI： |
| 中文关键词: 肺表面活性物质 新生儿呼吸窘迫综合征 经鼻持续气道正压通气 呼吸支持 时间窗 |
| 英文关键词: Pulmonary surfactant Neonatal respiratory distress syndrome Nasal continuous positive airway pressure Respiratory support Time window |
| 基金项目:湖南省卫计委科研基金课题（编号：A2016012） |
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| 中文摘要: |
| 目的：探讨肺表面活性物质（PS）治疗新生儿呼吸窘迫综合征（NRDS）前给予经鼻持续气道正压通气（nCPAP）呼吸支持的最佳时间窗。方法：选择2017年1月至2019年12月期间我院收治的NRDS患儿100例。根据随机数字表法分为A组（给予PS前预先进行小于2h的nCPAP，n=33）、B组（给予PS前预先进行2-4h的nCPAP，n=33）和C组（立即给予PS，n=34）。对比三组患儿的血气分析指标、肺功能指标、临床指标和并发症发生率。结果：A组、B组给予PS后4h、给予PS后24h动脉血氧分压（PaO2）、pH值高于C组，且B组高于A组（P<0.05），而动脉二氧化碳分压（PaCO2）低于C组，且B组低于A组（P<0.05）。A组、B组给予PS后4h、给予PS后24h潮气量（VT）、肺动态顺应性（CD）高于C组，且B组高于A组（P<0.05），而吸气阻力（Raw）低于C组，且B组低于A组（P<0.05）。B组用药后3天内需气管插管行机械通气例数少于A组和C组，住院时间短于A组和C组（P<0.05），A组、C组的用药后3天内需气管插管行机械通气例数、住院时间对比无明显差异（P>0.05）。三组患儿并发症发生率未见统计学差异（P>0.05）。结论：给予PS前预先进行2-4h的nCPAP，可较好地改善患儿血气分析指标和肺功能，有助于改善患儿预后。 |
| 英文摘要: |
| Objective: To explore the optimal time window of respiratory support with nasal continuous positive airway pressure (nCPAP) before pulmonary surfactant (PS) treatment for neonatal respiratory distress syndrome (NRDS). Methods: 100 children with NRDS who were admitted from January 2017 to December 2019 were selected. According to the random number table method, they were divided into group A (nCPAP less than 2h before PS administration, n=33), group B (nCPAP 2-4h before PS administration, n=33) and group C (PS administration immediately, n=34). The blood gas analysis indexes, pulmonary function indexes, clinical indexes and complication rate of the three groups were compared. Results: The arterial oxygen partial pressure (PaO2) and pH value of the group A and the group B at 4h after PS administration and 24h after PS administration were higher than those of the group C, and the group B was higher than the group A (P<0.05). The arterial carbon dioxide partial pressure (PaCO2) was lower than that of the group C, and the group B was lower than the group A (P<0.05). The volume?tidal (VT) and lung dynamic compliance (CD) of the group A and group B at 4h after PS administration and 24h after PS administration were higher than those of the group C, and the group B was higher than the group A (P<0.05), while air way?resistance (Raw) was lower than that of the group C, and the group B was lower than the group A (P<0.05). The number of cases requiring endotracheal intubation for mechanical ventilation 3 days after medication of the group B was less than that of the group A and group C, and the length of hospital stay was shorter than that of the group A and group C (P<0.05). There were no significant differences in the number of cases requiring endotracheal intubation for mechanical ventilation 3 days after medication and the length of hospital stay of the group A and group C (P>0.05). There was no significant difference in the incidence of complications of the three groups (P>0.05). Conclusion: The nCPAP for 2-4h before PS administration can improve the blood gas analysis index and pulmonary function of children, which is helpful to improve the prognosis of children. |
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