高频振荡通气联合肺表面活性物质治疗早产儿肺透明膜病的临床观察(1)
【摘 要】目的：探究高频振荡通气联合肺表面活性物质治疗早产儿肺透明膜病的疗效。方法：选取我院2016年3月-2017年3月收治的55例患者为研究对象，分为两组，观察组采用高频振荡通气联合肺表面活性物质治疗，对照组则予以机械通气联合肺表面活性物质治疗，观察两组治疗前后的血气指标及治愈率。结果：观察组血气指标变化明显优于对照组(P<0.05)；而在临床治愈上，观察组高于对照组，但差异较小(P>0.05)。并发症发面，观察组心衰、肾衰等并发症发病率明显低于对照组，差异显著(P<0.05)。结论：高频振荡通气联合肺表面活性物质治疗早产儿肺透明膜病治愈效果极佳，故应在临床中推广应用。
【关键词】高频振荡通气；肺表面活性物质；透明膜病
Abstract Objective： To investigate the effect of high frequency oscillatory ventilation combined with pulmonary surfactant on the treatment of hyaline membrane disease in preterm infants. Methods： Fifty-five patients admitted to our hospital from March 2016 to March 2017 were selected and randomly divided into two groups. The observation group was treated with high-frequency oscillatory ventilation and pulmonary surfactant， and the control group was given mechanical ventilation. Pulmonary surfactant treatment， observed before and after treatment of blood gas indicators and cure rate. Results： The change of blood gas index in the observation group was significantly better than that in the control group (P<0.05). In the clinical cure， the observation group was higher than the control group， but the difference was smaller (P>0.05). The incidence of complications was increased. The incidence of complications such as heart failure and renal failure in the observation group was significantly lower than that in the control group (P<0.05). Conclusion： High-frequency oscillatory ventilation combined with pulmonary surfactant can be used to treat pulmonary hyaline membrane disease in preterm infants with excellent curative effect， so it should be popularized and applied in clinical practice.
Key words： High-frequency oscillatory ventilation； Pulmonary surfactant； Hyaline membrane disease
【中圖分类号】 R969 .4 【文献标识码】 B 【文章编号】 1672-3783(2018)04-03-045-01
早产儿非透明膜病(HMD)是新生儿科临床中较为常见的疾病，其多被称为新生儿呼吸窘迫综合征。该症状指患儿在出生后出现呼吸困难、呼吸衰竭等症状。据相关研究[1]显示，该疾病发病机制复杂，发病特点典型，即肺发育不够成熟、肺表面活性物质缺失。该疾病发病迅速，且容易引发系统疾病，故致死率极高。当下临床中多以机械通气联合肺表面活性物质治疗，但整体效果欠佳。高频振荡通气联合肺表面活性物质治疗为近年来临床中应用的新型治疗方法，其效果得到众多研究者的肯定，故本文以我院55例患儿为研究对象，以对照分析方式，就新型高频振荡通气联合肺表面活性物质治疗的临床效果进行研究，报道如下。
1 资料与方法
1.1 临床资料 选取我院55例早产儿肺透明膜病患者为研究对象，按照治疗方法差异将患儿进行分组，观察组32例，其中男17例，女15例，孕周28-34周(31.12±1.78周)，入院年龄0.6-12 h(3.23±2.33h)；胸部X线分歧显示，Ⅳ期4例，Ⅲ期21例，Ⅱ期7例。对照组23例，其中男13例，女10例，孕周27-33周(31.55±1.81周)，入院年龄0.5-11 h(3.25±2.44h)；胸部X线分期显示，Ⅳ期3例，Ⅲ期15例，Ⅱ期5例。本研究经国家伦理委员会批准，且患儿家属自愿参与并签署知情同意书。对比两组患儿基本临床资料差异并不显著(P>0.05)，具有可比性。
纳入标准：符合《实用新生儿学》[2]关于肺透明膜病的诊断标准；出生体重小于2kg；胎龄35周以下；需接受通气治疗患儿。
排除标准：产前检查有感染那病史；早产儿先天性肺发育不良；出生后出现重度窒息，且未经正确复苏患儿；未完成治疗自愿放弃患儿。, 百拇医药(何春燕)
【关键词】高频振荡通气；肺表面活性物质；透明膜病
Abstract Objective： To investigate the effect of high frequency oscillatory ventilation combined with pulmonary surfactant on the treatment of hyaline membrane disease in preterm infants. Methods： Fifty-five patients admitted to our hospital from March 2016 to March 2017 were selected and randomly divided into two groups. The observation group was treated with high-frequency oscillatory ventilation and pulmonary surfactant， and the control group was given mechanical ventilation. Pulmonary surfactant treatment， observed before and after treatment of blood gas indicators and cure rate. Results： The change of blood gas index in the observation group was significantly better than that in the control group (P<0.05). In the clinical cure， the observation group was higher than the control group， but the difference was smaller (P>0.05). The incidence of complications was increased. The incidence of complications such as heart failure and renal failure in the observation group was significantly lower than that in the control group (P<0.05). Conclusion： High-frequency oscillatory ventilation combined with pulmonary surfactant can be used to treat pulmonary hyaline membrane disease in preterm infants with excellent curative effect， so it should be popularized and applied in clinical practice.
Key words： High-frequency oscillatory ventilation； Pulmonary surfactant； Hyaline membrane disease
【中圖分类号】 R969 .4 【文献标识码】 B 【文章编号】 1672-3783(2018)04-03-045-01
早产儿非透明膜病(HMD)是新生儿科临床中较为常见的疾病，其多被称为新生儿呼吸窘迫综合征。该症状指患儿在出生后出现呼吸困难、呼吸衰竭等症状。据相关研究[1]显示，该疾病发病机制复杂，发病特点典型，即肺发育不够成熟、肺表面活性物质缺失。该疾病发病迅速，且容易引发系统疾病，故致死率极高。当下临床中多以机械通气联合肺表面活性物质治疗，但整体效果欠佳。高频振荡通气联合肺表面活性物质治疗为近年来临床中应用的新型治疗方法，其效果得到众多研究者的肯定，故本文以我院55例患儿为研究对象，以对照分析方式，就新型高频振荡通气联合肺表面活性物质治疗的临床效果进行研究，报道如下。
1 资料与方法
1.1 临床资料 选取我院55例早产儿肺透明膜病患者为研究对象，按照治疗方法差异将患儿进行分组，观察组32例，其中男17例，女15例，孕周28-34周(31.12±1.78周)，入院年龄0.6-12 h(3.23±2.33h)；胸部X线分歧显示，Ⅳ期4例，Ⅲ期21例，Ⅱ期7例。对照组23例，其中男13例，女10例，孕周27-33周(31.55±1.81周)，入院年龄0.5-11 h(3.25±2.44h)；胸部X线分期显示，Ⅳ期3例，Ⅲ期15例，Ⅱ期5例。本研究经国家伦理委员会批准，且患儿家属自愿参与并签署知情同意书。对比两组患儿基本临床资料差异并不显著(P>0.05)，具有可比性。
纳入标准：符合《实用新生儿学》[2]关于肺透明膜病的诊断标准；出生体重小于2kg；胎龄35周以下；需接受通气治疗患儿。
排除标准：产前检查有感染那病史；早产儿先天性肺发育不良；出生后出现重度窒息，且未经正确复苏患儿；未完成治疗自愿放弃患儿。, 百拇医药(何春燕)