摘要
目的观察肺表面活性物质联合双水平气道正压通气(BiPAP)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法选取2014年1月—2017年1月三亚市妇幼保健院收治的NRDS患儿84例,随机分为对照组和观察组,每组42例。对照组患儿给予BiPAP治疗,观察组患者给予肺表面活性物质联合BiPAP治疗。比较两组患儿机械通气时间、氧疗时间及住院时间;治疗48 h后,评估两组患儿临床疗效;比较两组患儿治疗前和治疗48 h后动脉血气分析指标、氧交换指标及通气指标;观察两组患儿治疗期间并发症发生情况。结果观察组患儿机械通气时间、氧疗时间及住院时间短于对照组(P<0.05);治疗48 h后观察组患儿临床疗效优于对照组(P<0.05)。治疗前两组患儿动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、pH值、PaO_2/吸入氧浓度(FiO_2)及PaO_2/肺泡氧分压(PAO_2)比较,差异无统计学意义(P>0.05);治疗48 h后观察组患儿PaO_2、pH值、PaO_2/FiO_2及PaO_2/PAO_2高于对照组,PaCO_2低于对照组(P<0.05)。治疗前两组患儿平均气道阻力(MAP)和呼气末正压(PEEP)比较,差异无统计学意义(P>0.05);治疗48 h后观察组患儿MAP和PEEP低于对照组(P<0.05)。观察组患儿治疗期间并发症发生率低于对照组(P<0.05)。结论肺表面活性物质联合BiPAP治疗NRDS的临床疗效确切,能有效缩短患儿机械通气时间、氧疗时间及住院时间,改善患儿动脉血气分析指标、氧交换能力及通气功能,且安全性较高。
Objective To observe the clinical effect of pulmonary surfactant combined with bi - level positive airway pressureventilation （ BiPAP） on neonatal respiratory distress syndrome （ NRDS） . Methods A total of 84 neonates with NRDS were selected in Sanya Maternal and Child Health Care Service Center from January 2014 to January 2017, and they were randomly divided into control group and observation group, each of 42 cases. Neonates of control group received BiPAP, while neonates of observation group received pulmonary surfactant combined with BiPAP. Duration of mechanical ventilation, duration of oxygen inhalation, hospital stays, clinical effect after 48 hours of treatment, arterial blood - gas analysis results, index of oxygen exchange and ventilation related indicators before treatment and after 48 hours of treatment were compared between the two groups, and incidence of complications was observed during the treatment. Results Duration of mechanical ventilation, duration of oxygen inhalation and hospital stays of observation group were statistically significantly shorter than those of control gruop （P 〈 0.05）. Clinical effect of observation group was statistically significantly better than that of control group after 48 hours of treatment （P 〈0.05）. No statistically significant differences of PaO2 PaCO2, pH, PaO2/FiO2 or PaO2/PAO2 was found between the two groups before treatment （ P 〉 0. 05 ） ; after 48 hours of treatment, PaO2, pH, PaO2/FiO2 and PaO2/PAO2 of observation group were statistically significantly higher than those of control group, while PaCO2 of observation group was statistically significantly lower than that of control group （ P 〈 0. 05 ） . No statistically significant differences of MAP or PEEP was found between the two groups before treatment （ P 〉 0. 05 ） , while MAP and PEEP of observation group were statistically significantly lower than those of control group after 48 hours of treatment （ P 〈 0. 05 ） . Incidence of complications of observation group was statistically significantly lower than that of control group during the treatment （ P 〈 0. 05 ） . Conclusion Pulmonary surfactant combined with BiPAP has certain clinical effect in treating neonates with NRDS, can effectively shorten the duration of mechanical ventilation, duration of oxygen inhalation and hospital stays, improve the arterial blood - gas analysis results, oxygen exchange capacity and ventilation function, and is relatively safe
出处
《实用心脑肺血管病杂志》
2017年第7期77-80,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
海南省卫生厅科学研究课题(琼卫2015 PT-38)
关键词
呼吸窘迫综合征
新生儿
肺表面活性物质
双水平气道正压通气
治疗结果
Respiratory distress syndrome, newborn
Pulmonary surfactants
Bi - level positive airway pressure ventilation
Treatment outcome
