新生儿呼吸窘迫综合征治疗研究进展

Research Progress in the Treatment of Neonatal Respiratory Distress Syndrome

摘要: 新生儿呼吸窘迫综合征(NRDS)是新生儿时期常见的一种呼吸系统疾病，多见于早产儿，病情进展迅速，死亡率高，对儿童的健康和生命构成极大威胁。因此在对于NRDS患儿治疗时，肺表面活性物质的替代使用中，早期选择性使用肺表面活性物质并结合微创技术(LISA/MIST)的方法正慢慢成熟并应用到临床中，并且引入肺部超声评分这一手段还能帮医护人员更具针对性的治疗工作。同时依靠鼻腔持续正压通气(NCPAP)，搭配高流量鼻导管通气(HFNC)和鼻间歇正压通气(NIPPV)的方式，能够降低机械通气的依赖，进而减轻肺部损伤。在药物干预这一块，产前用皮质类固醇做好预防工作、产后辅以咖啡因用药，再加上小剂量类固醇的对症治疗，让患儿的预后情况有了不小的改善。对于那些病情危重的患儿来说，体外膜肺氧合(ECMO)技术的运用，依旧是一种切实可用的救治办法。智能监测技术的融合使用，推动NRDS的临床管理一步步朝着个体化、微创化和抗炎化的方向发展。这套规范化的综合治疗方案，既明显提升了临床治疗效果，也有效降低了各类并发症的出现概率。

Abstract: Neonatal Respiratory Distress Syndrome (NRDS) is a common respiratory disease in newborns, mostly occurring in premature infants. The condition progresses rapidly and has a high mortality rate, posing a significant threat to the health and life of children. Therefore, in the treatment of NRDS patients, the use of pulmonary surfactant replacement therapy, with the early selective use of pulmonary surfactant combined with minimally invasive techniques (LISA/MIST), is gradually maturing and being applied in clinical practice. The introduction of lung ultrasound scoring also helps healthcare professionals to carry out targeted treatment. At the same time, relying on nasal continuous positive pressure ventilation (NCPAP), combined with high-flow nasal cannula ventilation (HFNC) and nasal intermittent positive pressure ventilation (NIPPV), can reduce the reliance on mechanical ventilation and thereby alleviate lung damage. In terms of drug intervention, using corticosteroids before birth for prevention, supplementing with caffeine after birth, and combined with symptomatic treatment with low-dose steroids, have significantly improved the prognosis of these children. For those critically ill children, the application of extracorporeal membrane oxygenation (ECMO) technology remains a practical and effective treatment method. The integration of intelligent monitoring technology promotes the clinical management of NRDS to develop step by step towards individualization, minimally invasive, and anti-inflammatory directions. This standardized comprehensive treatment plan not only significantly improves clinical treatment effects but also effectively reduces the probability of various complications.