目的 分析早产儿肺透明膜病经肺泡表面活性物质联合鼻塞式持续气道正压通气治疗的效果。方法 选取黄山市人民医院2014年11月-2017年11月收治的肺透明膜病早产儿50例,依据不同治疗方法分为两组,24例施予鼻塞式持续气道正压通气治疗者为对照组,26例予以肺泡表面活性物质联合鼻塞式持续气道正压通气治疗者为试验组,比较两组血气分析指标、呼吸力学与并发症发生情况。结果 治疗后,试验组血氧饱和度(SpO₂)、血氧分压(PaO₂)、二氧化碳分压(PaCO₂)、氢离子浓度指数(pH)优于对照组,且试验组呼吸时间常数(RCexp)、呼气峰流量(PEF)均较对照组高,差异均有统计学意义(P均<0.05);试验组并发症发生率为低于对照组(7.69% vs. 28.00%),差异有统计学意义(P<0.05)。结论 通过肺泡表面活性物质联合鼻塞式持续气道正压通气治疗早产儿肺透明病,可有效改善其血气分析指标,并提升RCexp、PEF,达到减少并发症、改善预后的效果,值得推广。

Objective To investigate the effect of alveolar surfactant combined with nasal plug continuous positive airway pressure ventilation in the treatment of pulmonary hyaline membrane disease in preterm infants. Methods Totally 50 cases treated in Huangshan People′s Hospital from November 2014 to November 2017 were enrolled in this study.The participants were divided into two groups, the control group (n=24) was given nasal continuous positive airway pressure therapy, and the experimental group (n=26) was treated with pulmonary surfactant combined with nasal continuous positive airway pressure ventilation.Blood gas analysis index, incidence of complications and respiratory mechanics of the two groups were collected and compared. Results Percutaneous oxygen saturation(SpO₂), partial pressure of oxygen(PaO₂), partial pressure of carbon dioxide (PaCO₂) and hydrogen ion concentration (pH) in experimental group were better than those in control group after treatment (P＜0.05).Also, the levels of breathing time constant (RCexp) and peak expiratory flow (PEF) were significantly higher in the experimental group than those in the control group(P＜0.05).The complication rate of experimental group was 7.69%, which was significantly lower than that of control group (28%)(P＜0.05). Conclusion Pulmonary surfactant combined with nasal continuous positive airway pressure can effectively improve the blood gas analysis index, increase RCexp and PEF in preterm infants with pulmonary hyaline disease, thereby reducing complications and improving prognosis.