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新生儿呼吸窘迫综合征患儿的X线表现及临床分析

[X-ray findings and clinical analysis for newborn infants with neonatal respiratory distress syndrome].

作者信息

Zhao Zhi-mei, Yang Lin, Cui Bin

机构信息

Department of Paediatrics, Yuquan Hospital of Tsinghua University, Beijing 100049, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2007 Dec;32(6):1069-74.

Abstract

OBJECTIVE

To discuss X-ray findings and clinical analysis of neonatal respiratory distress syndrome (NRDS), and to compare the use of pulmonary surfactant and mechanical ventilation.

METHODS

The X-ray findings, clinical characteristics, and therapy analysis of 32 babies with NRDS were studied retrospectively from Jan. 2004 to Dec. 2006. The correlation between X-ray findings and clinical characteristics was analyzed. The advantages of surfactant replacement therapy, compared with mechanical ventilation alone were discussed.

RESULTS

According to X-ray findings all babies were divided into Stage I (n=7), Stage II (n=11), Stage III (n=8), Stage IV (n=3), and normal (n=3). Of them, 18 were very low-birth-weight neonates, and 11 were very low-birth-weight neonates. Twenty received surfactant replacement therapy, after the diagnosis of NRDS had been established clinically and radiographically. NRDS had classic chest radiographic findings. There was statistically significant difference between the fetal age or birth weight and the first time X-findings (P<0.05), and difference existed between the use of surfactant and nCPAP alone (P<0.01).

CONCLUSION

The younger the fetal age and the lower the birth weight, the more likely that the first X-ray findings would be below Stage II. Early surfactant replacement therapy with extubation to nCPAP for infants with NRDS was not only safe and beneficial, but also it significantly reduced both the need for mechanical ventilation and the briefer requirement for respiratory supports.

摘要

目的

探讨新生儿呼吸窘迫综合征(NRDS)的X线表现及临床分析,并比较肺表面活性物质与机械通气的应用情况。

方法

回顾性分析2004年1月至2006年12月期间32例NRDS患儿的X线表现、临床特征及治疗分析。分析X线表现与临床特征之间的相关性。讨论与单纯机械通气相比,表面活性物质替代疗法的优势。

结果

根据X线表现,将所有患儿分为Ⅰ期(n = 7)、Ⅱ期(n = 11)、Ⅲ期(n = 8)、Ⅳ期(n = 3)及正常(n = 3)。其中,18例为极低出生体重儿,11例为超低出生体重儿。20例在临床和影像学确诊NRDS后接受了表面活性物质替代疗法。NRDS有典型的胸部X线表现。胎龄或出生体重与首次X线表现之间存在统计学显著差异(P < 0.05),表面活性物质的使用与单纯使用nCPAP之间也存在差异(P < 0.01)。

结论

胎龄越小、出生体重越低,首次X线表现低于Ⅱ期的可能性越大。对于NRDS患儿,早期应用表面活性物质替代疗法并拔管至nCPAP不仅安全有益,而且显著减少了机械通气的需求以及呼吸支持的短暂需求。

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