摘要
目的探讨早期使用鼻塞持续气道正压通气(nCPAP)治疗极低出生体质量患儿呼吸窘迫综合征(RDS)的疗效。方法回顾性分析99例确诊为RDS的极低出生体质量患儿的临床资料。其中,出生后2 h内即开始nCPAP辅助呼吸的40例设为治疗组,出生后2 h内未使用nCPAP辅助呼吸的59例设为对照组。比较2组患儿的病死率、血气及胸片变化、氧疗、并发症、住院时间、恢复出生体质量时间等指标。结果治疗组病死率为7.5%,对照组为23.3%(P<0.05);治疗组治疗2 h后血气指标改善较对照组明显,差异有统计学意义(P<0.05);治疗24、48 h后2组血气情况均有改善。在治愈的患儿中,治疗组和对照组机械通气比例分别为37.1%、64.9%(P<0.05);机械通气时间分别为(2.46±2.11)d和(6.79±2.86)d(P<0.01);总氧疗时间治疗组为(17.41±13.89)d,对照组为(28.94±12.38)d(P<0.01);治疗组和对照组住院天数分别为(40.49±10.45)d和(51.73±15.04)d(P<0.01);恢复出生体质量时间分别为(9.71±4.818)d和(13.30±4.807)d(P<0.01);支气管肺发育不良发生率分别为8.6%和29.7%(P<0.05)。结论对于极低出生体质量患儿合并RDS,早期使用nCPAP可明显降低病死率,改善近期预后,疗效安全可靠。
Objective To investigate the efficacy and safety of early use of nasal continuous positive airways pressure （nCPAP） in treatment of very low-birth-weight infants with respiratory distress syndrome （RDS）. Methods Ninety-nine very low-birth-weight infants with diagnosis of respiratory distress syndrome were studied retrospectively. Forty patients who began to have nC- PAP assisted respiration within two hours after birth were allocated to treatment group, and other fifty-nine who did not use nCPAP within 2 hours after birth were allocated to control group. The mortality, changes in blood gases, chest X-ray, oxygen therapy, complication, inpatient days and time to regain birth weight were compared between the two groups. Results The fatality in the treatment group was 7.5 %, while in the control group was 23.3 % （P = 0. 039, OR = 0. 266, 95 % CI： 0. 071-0. 997）. After 2 hours the change of blood gas in the treatment group improved signifi- cantly compared with that in the control group, and the difference was statistically significant （P 〈 0.05）. 24 and 48 hours after treatment, the two groups showed improvement in blood gas. In the cured cases, the ratio of using mechanical ventilation（MV） in the treatment group was 37.1%, while the control group 64.9 % （P 〈 0.05, OR = 0.32, 95 % CI ： 0. 122-0. 838）. And the total time with treatment of MV in the treatment group and the control group were （2.46 ± 2.11） d and （6.79 ± 2.86） d（t = 4.79, P〈0. 01）. The total time of oxygen therapy in the treatment group an＆he control group were （ 17.41 ± 13.8 9 ） days and （ 2 8.9 4 ±12.3 8 ） days （ t = 3.6 7 2, P 〈 0.0 1 ） . The inpatient days in the treatment group and the control group were （ 4 0.4 9 ±1 0.4 5 ）days and （51.73± 15.04） days （t = 3. 665, P〈0.01）, the time to regain birth weight in the treatment group and the control group were （9.71 ± 4. 818） days and （13.30 ± 4. 807）days （ t = 3 . 1 5 8 , P 〈 0 . 0 1 ） , and the ratio of BPD in the treatment group and the control group were 8.6 % and 29.7 % （P 〈 0.05, OR = 0. 222, 95 % CI ： 0. 056 - 0. 879）. Conclusion For very low-birth-weigh infants with RDS, early use of nCPAP may reduce mortality, improve prognosis and sa{ety.
出处
《实用临床医药杂志》
CAS
2013年第7期51-54,共4页
Journal of Clinical Medicine in Practice
