652安徽医学AnhuiMedicalJournal第3l卷第6期2010年6月珂立苏联合鼻塞式持续气道正压通气预防早产儿呼吸窘迫综合征的临床观察丁为秀李洁谢晓曼何贤明张海峰汤薇薇[摘要]目的观察国产肺泡表面活性物质(珂立苏)联合鼻塞式持续气道正压通气(N—CPAP)预防早产儿呼吸窘迫综合征(RDS)的效果。方法将l8例孕32周前出生且在出生后6h内人NICU的早产儿,在常规治疗的基础上,经气管插管滴入珂立苏后拔管,联合N—CPAP辅助呼吸,观察应用珂立苏前、后血气分析指标(动脉氧分压及二氧化碳分压)的变化、x线胸片的变化以及N—CPAP参数的变化(氧浓度、呼气末正压)。结果应用珂立苏联合N—CPAP预防RDS,可明显改善血气指标及氧合情况;N—CPAP参数(FiO、PEEP)明显下调。结论珂立苏联合N—CPAP预防RDS疗效确切,可明显改善血气指标及氧合状况、下调N—CPAP所需的参数、缩短N—CPAP使用的总时问。[关键词]肺泡表面活性物质;早产儿;呼吸窘迫综合征doi:10.3969/j.issn.1000—0399.2010.06.043Clinicalobserrafionondomestic(China)pulmonarysurfactant—Calsurfjoint、vithN—CPAPforrespiratorydistresssyn·dromeinprematureinfantsD堍Weixiu,Lim,XieXiaoman,etalChildrenIntensiveCareTherapyofJnPeopleHospital,[m缸n237005,China[Abstract]0bjectiveToobservetheeffectofdomestic(China)pulmonarysurfactant—Calsurf,jointwithn—CPAPinpreventingprematureinfantsfromRespiratoryDistressSyndrome(RDS).MethodsSelect18casesofprematureinfantsbefore32weeksgestationalagewhowereadmittedtoNICUwithin6hoursafterbirth.Basedonconventionaltreatment,weremovethetubeafterCalsurfbeinginstilledintothetracheaandthen—CPAPventilationwasset.Thenweobservethechangesofthebloodgasanalysiselements—PO2&PCO2,X—rayofchestandtheparameterofn—CPAP(FiO2&PEEP).ResultsCalsurfjointwithn—CPAPcansignificantlyimprovebloodgasanalysisindi—cationsofbloodgasanalysisandPO2.Itcanalsoimprovethex—rayofchestandmeanwhilereducetheparameterofn—CPAP(FiO2&PEEP).ConclusionItisefectivetouseCalsurfjointwithn—CPAPtopreventprematureinfantsfromrespiratorydistresssyndrome(RDS).Itcansignificantlyimprovebloodgasanalysis&PO2andmeanwhilereducetheparameterofn—CPAP.Asaresult,totaltimeofn—CPAPcanbesho~ened.[Keywords]Thealveolarsurfaceactivesubstances;Premature;Respiratorydistresssyndrome作者单位:237005六安市人民医院小儿重症监护科(P/Nieu)参考文献[1][2][3][4]CunninghalnFG,GantNF,LevenoKJ,eta1.WilliamsObste—rtrics,20thed.AppletonLange,1997:808.刘棣I临.全国早产儿及低体重儿学术会议纪要.中华妇产科杂志,1992,27(2):119.AndemsonKE,IngermarssonI,UimstermU,eta1.Inhibitonofprostaglandin—induceduterneactivitybynifegipine.BrJObsetetGynaecol,200l,86(3):175.UimstemU,AnderssonKR,WingerupL.Treatmentofprema—turelaborwiththecalciumantagonistnifedipine.ArchGyne—col,2005,229(1):1.[5][6][7]KupfermineM,LessingJB,YaronY,eta1.nifegipineversusonfetalandmaternalhemodynamicsinptegantsheep.AmJObestetGynecol,2003100(12):1090.HarakeB,GilbertRD,AshwalS,eta1.nifegipine:efectsonfetalandmeternalhemodynamicsinpe:tegant.Sheep.AmJObetetGynecol,2007,157(4):1003.MichaelM,MorettiMD,FionaM,eta1.Theefectofnife—gipinetherapyonfetalandplacentaldopplerwaveformsinporeclampsiaremotefromterm.AmJObestetGynecol,2006,163(6):1844.(2010-03—11收稿2010-04-26修回)嚣丁为秀等:珂立苏联合鼻塞式持续气道正压通气预防早产儿呼吸窘迫综合征的f床观察653早产儿呼吸窘迫综合征(RDS)是早产儿死亡的主要原因。肺泡表面活性物质联合鼻塞式持续气道正压通气(N—CPAP)在预防治疗早产儿RDS方面取得了确切的疗效。目前国内外均在推广应用。我院NI...