| 摘要: |
| 目的:探讨经细导管注入牛肺表面活性物质(PS)联合双相呼吸道正压通气治疗新生儿呼吸窘迫综合征(NRDS)的疗效及安全性。方法:选取我院新生儿科2016年2月至2018年6月收治的94例NRDS患儿,按随机数表法分为观察组和对照组各47例。所有患儿均采用常规支持治疗,在此基础上对照组给予双相呼吸道正压通气结合硅胶管(内径0.25 mm)注入PS治疗,观察组给予双相呼吸道正压通气结合经细导管(内径0郾1 mm)注入PS治疗,6 h后比较两组患儿血气指标(pH、PaO2、PaCO2、OI)、通气相关指标(MAP、PEEP、FiO2、吸氧时间)、症状消失时间、住院时间、住院费用、疗效、存活率及并发症发生情况。结果:观察组有效率95.74%,显著高于对照组的87.23%(P<0.05)。治疗前两组患儿pH、PaO2、PaCO2、OI水平比较差异无统计学意义(P>0.05),治疗后观察组pH、PaO2、OI水平明显高于对照组,PaCO2水平明显低于对照组(P<0.05)。治疗开始时,两组患儿
MAP、PEEP、FiO2水平比较差异无统计学意义(P>0.05),治疗6 h后,观察组MAP、FiO2水平明显低于对照组,PEEP水平明显高于对照组(P<0.05)。观察组患儿吸氧时间、症状消失时间、住院费用均少于观察组(P<0.05)。观察组患儿存活率95.74%,明显高于对照组的89.36%;观察组并发症发生率8.51%,显著低于对照组的17.02% (P<0.05)。结论:经细导管注入牛肺表面活性物质联合双相呼吸道正压通气治疗NRDS能够提高患儿肺泡气体交换功能,改善缺氧状态,降低病死率,疗效更显著,安全性更高,值得临床推广。 |
| 关键词: 新生儿呼吸窘迫综合征 肺表面活性物质 机械通气 肺泡表面张力 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2019.08.010 |
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| 基金项目: |
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| Efficacy and Safety of Bovine Pulmonary Surfactant via Thin Catheter Combined with Biphasic Positive Airway Pressure in the Treatment of Children with Neonatal Respiratory Distress Syndrome |
| Liu Yingzhan, Bo Haiping |
| (Jiawang Branch of Xuzhou Medical University Affiliated Hospital, Jiawang District People's Hospital,Jiangsu Xuzhou 221011,China) |
| Abstract: |
| Objective: To probe into the efficacy and safety of bovine pulmonary surfactant (PS) via thin catheter combined with biphasic positive airway pressure in the treatment of children with neonatal respiratory distress syndrome (NRDS). Methods: A total of 94 children with NRDS admitted to our hospital from Feb. 2006 to Jun. 2018 were enrolled to be divided into the observation group and the control group via the random number table, with 47 cases in each group. All patients were given routine supportive treatment, on this basis, the control group was given biphasic positive airway pressure combined with bovine PS via the silicone tube (inner diameter of 0.25 mm), while the observation group received biphasic positive airway pressure combined with PS via the thin catheter (inner diameter of 0.1 mm). After treatment of 6 h, blood gas indicators (pH, PaO2, PaCO2, OI), ventilation related indicators (MAP,PEEP, FiO2, inhalation time of oxygen), disappearance time of symptoms, length of stay, hospitalization costs and efficacy, survival rate and complications of two groups were compared. Results: The effective rate of the observation group was 95.74%, significantly higher than 87.23% of the control group (P<0.05). There was no significant difference in pH, PaO2 , PaCO2 and OI levels between two groups before treatment (P>0.05). After treatment, the levels of pH, PaO2 and OI in the observation group were significantly higher than those in the control group, and the level of PaCO2 was significantly lower than that in the control group (P<0.05). At the beginning of the treatment, there was no significant difference in levels of MAP, PEEP and FiO2 between two groups (P>0.05). After treatment of 6 h, the levels of MAP and FiO2 in the observation group were significantly lower than those in the control group, while the level of PEEP was significantly higher than that in the control group (P<0.05). The inhalation time of oxygen, disappearance time of symptoms and hospitalization costs of the observation group were lower than those of the control group (P<0.05). The survival rate of
the observation group was 95.74%, significantly higher than that of the control group (89.36%). The complication rate of the observation group was 8.51%, significantly lower than that of the control group (17.02%, P<0.05). Conclusion: Bovine pulmonary surfactant via thin catheter combined with biphasic positive airway pressure in the treatment of children with NRDS can improve the function of alveolar gas exchange in children, improve the hypoxia status, reduce the mortality, and has better curative effect with higher safety, which is worthy of clinical promotion. |
| Key words: neonatal respiratory distress syndrome pulmonary surfactant mechanical ventilation alveolar surface tension |
