摘要
目的:分析新生儿重度急性呼吸窘迫综合征(ARDS)生存状况和临床诊疗。方法:收治新生儿ARDS患儿82例,分析患儿的血气、生命体征、肝功能、电解质、胸片、肾功能、头部CT/B超、心脏彩超等指标,比较患儿的存活率与死亡率。结果:按照最终治疗结果分为治愈组和非治愈组,治愈54例(65.9%),死亡28例(34.1%)。经胸片检查,斑状阴影或肺部毛玻璃33例(40.2%)、支气管充气征24例(29.3%)、白肺和心影消失23例(28.0%)、持续性肺动脉高压65例(79.3%)。治愈组患儿的PaO_2检测结果明显高于非治愈组,治愈组患儿的FiO_2明显低于非治愈组。治愈组患儿呼吸机模式更换(SIMV-HFOV)6例(7.3%),少于非治愈组,SIMV中治愈组患儿的初定参数中FiO_2相较于非治愈组明显降低,治愈组患儿PIP值相较于非治愈组明显降低(P<0.05)。结论:新生儿ARDS具有极高的病死率,且现阶段诊疗标准尚未得到统一,借助呼吸机进行治疗,其初定值FiO_2可判断患儿预后情况。
Objective:To analyze the survival condition and clinical diagnosis and treatment of severe acute respiratory distres ssyndrome(ARDS) in neonates.Methods:82 neonates with ARDS were selected.The blood gas,vital signs,liver function,electrolyte,chest X-ray,renal function,head CT/B ultrasound,heart color doppler and other indicators were analyzed.The survival rate andmortality of children were compared.Results:According to the final treatment results,they were divided into the cure group and thenon cure group.54 cases(65.9%) were cured,and 28 cases(34.1%) were cured.By chest X-ray examination,33 cases(40.2%) weremottling or pulmonary ground glass;24 cases(29.3% ) were air bronchogram;23 cases(28% ) were white lung and heart shadowdisappeared;65 cases(79.3%) were persistent pulmonary hypertension.The PaO2 result of the cure group was significantly higherthan that of the non cure group,and the FiO2 of the cure group was significantly lower than that of the non cure group.6cases(7.3%) of ventilator mode change(SIMV-HFOV) of the cure group was less than that of the non cure group.In SIMV,the FiO2in the initial parameter of the cure group was significantly lower than that of the non cure group,and the PIP value of the curegroup was significantly lower than that of the non cure group(P<0.05).Conclusion:The neonatal ARDS has a very high mortality,and the current diagnosis and treatment standard has not yet been unified,with the help of a breathing machine for treatment,and the initial value of FiO2 can judge the prognosis of children.
作者
赵香丽
Zhao Xiangli(Department of Pediatrics,Dongming County Maternal and Child Health Hospital of Shandong Province 274500)
出处
《中国社区医师》
2017年第3期68-69,共2页
Chinese Community Doctors
关键词
重度急性呼吸窘迫综合征
新生儿
临床诊疗
生存状况
Severe acute respiratory distress syndrome
Neonates
Clinical diagnosis and treatment
Survival condition
