提高极早产儿成活率的临床研究.docVIP

提高极早产儿成活率的临床研究 　　【摘要】 目的：探讨应用预防为先，防治并重的治疗理念，早预防、早诊断、早治疗，提高极早产儿成活率。方法：选取2012年6月-2015年5月本院新生儿科重症监护室收治的胎龄小于32周的极早产儿作为治疗组，应用INSURE策略早期预防新生儿肺透明膜病，早预防；应用气管内吸引早期诊断新生儿肺出血，早诊断；应用高频振荡通气、常频通气、全自动外周静脉换血，早治疗，将关口前移，早期中止早产儿疾病进展，为基层医院创造抢救机会；选取2009年6月-2012年5月本院新生儿科重症监护室收治的胎龄小于32周的极早产儿作为对照组，仅采用一般治疗。比较两组患儿的相关指标的差异。结果：治疗组58例，发生NRDS 13例，发病率22.4%；发生肺出血2例，发病率3.4%；上机10例，上机率17.2%；抢救成功率达93.1%。对照组54例，发生NRDS 23例，发病率42.6%；发生肺出血10例，发病率18.5%；上机率31.4%；抢救成功率达74.1%。治疗组抢救成功率高于对照组，NRDS发病率、新生儿肺出血发病率均低于对照组，差异均有统计学意义（P0.05）。结论：采取预防为先，防治并重的治疗理念，可提高极早产儿抢救成功率，降低NRDS、新生儿肺出血发病率，值得在基层医院推广。 中国论文网 /6/view-7254737.htm 　　【关键词】 极早产儿； 成活率； 临床研究 　　Cinical Research of Enhancing the Survival Rate in Very Preterm Infants/FU Jian-ping， JIANG Hai-hong， YANG Lei，et al.//Medical Innovation of China，2016，13（08）：128-131 　　【Abstract】 Objective： To investigate application of the treatment concept that prevention first and combining prevention with cure， early prevention， early diagnosis， early treatment， improving the survival rate of very preterm infants. Method： Very preterm infants with gestational age less than 32 weeks in our hospital from June 2012 to May 2015 were collected as treatment group， INSURE strategy was applied to prevent neonatal pulmonary hyaline membrane disease early. Early diagnosed neonatal pulmonary hemorrhage with endotracheal attract technology， treated with high frequency oscillatory ventilation， conventional ventilation， and automatic peripheral venous shake-up in the early， thus suspended the preemies’ disease progression， created a rescue opportunity for primary hospital finally. Very preterm infants with gestational age of less than 32 weeks in our hospital from June 2009 to May 2012 were acted as controls. The differences of related indicators of Preterm infants were compared between the two groups.Result： There were 58 cases of extremely premature in the treatment group， 13 cases of NRDS， the morbidity rate was 22.4%， pulmonary hemorrhage occurred in 2 cases， accounted for 3.4%， there were 10