摘要
目的探讨多索茶碱联合经鼻双水平正压通气(BiPAP)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法将100例NRDS患儿随机分为观察组及对照组各50例,病情平稳后两组患儿均给予经鼻BiPAP治疗,观察组同时给予多索茶碱静脉滴注。比较两组患儿治疗前及治疗后12 h的血气指标;检测治疗前和治疗5 d后两组患儿外周静脉血中肿瘤坏死因子α(TNF-α)、巨噬细胞移动抑制因子-1(MIF-1)及高迁移率族蛋白-1(HMGB-1)水平;比较两组患儿机械通气状况及相关并发症的发生情况。结果治疗后,两组的血气指标均较前改善(均P <0. 05),且观察组的Pa O2、p H、氧合指数高于对照组,而Pa CO2低于对照组(均P <0. 05)。治疗5 d后,两组患儿的TNF-α、MIF-1、HMGB-1水平均较治疗前降低(均P <0. 05),且观察组以上指标均低于对照组(均P <0. 05)。两组患儿的无创正压总通气总时间、无创呼吸支持后有创呼吸支持比例、总有创呼吸支持比例及相关并发症的发生率比较,差异均无统计学意义(均P> 0. 05)。结论与单纯BiPAP治疗比较,多索茶碱联合经鼻BiPAP能更好地改善NRDS患儿的血气指标及炎症反应,且安全性较好。
Objective To investigate the clinical efficacy of doxofylline combined with nasal bi-level positive airway pressure( Bi PAP)for neonatal respiratory distress syndrome( NRDS). Methods A total of 100 children with NRDS were randomly divided into observation group and control group,with 50 cases in each group. Nasal Bi PAP was conducted in both groups after the children were in stable condition,and the observation group was also intravenously administered doxofylline. Before treatment and after 12 hours of treatment,the blood gas indices were compared between the two groups; before treatment and after 5 days of treatment,the levels of tumor necrosis factor alpha( TNF-α),macrophage migration inhibitor-1( MIF-1) and high-mobility group box-1 protein( HMGB-1) in peripheral venous blood were detected in both groups; the mechanical ventilation status and the incidence of related complications were compared between the two groups.Results After treatment,the blood gas indices of both groups were improved compared with the previous( all P < 0. 05),and Pa O2,p H and OI were higher but Pa CO2 was lower in the observation group compared with those in the control group( all P < 0. 05). After 5 days of treatment,the levels of TNF-α,MIF-1 and HMGB-1 were lower in both groups than the levels before treatment( all P < 0. 05),and the levels described above in the observation group were lower than those in the control group( all P < 0. 05). There were no statistically significant differences between the two groups in the total duration for non-invasive positive pressure ventilation,invasive respiratory support ratio after non-invasive respiratory support,total invasive respiratory support ratio,or incidence rate of related complications( all P > 0. 05). Conclusion For the children with NRDS,doxofylline combined with nasal Bi PAP can better improve the blood gas indices and inflammatory response compared with Bi PAP alone,and it is safe.
作者
冯金明
黄玉维
吴华
苏俊鸿
农常亮
FENG Jin-ming;HUANG Yu-wei;WU Hua;SU Jun-hong;NONG Chang-liang(Department of Pediatrics,the Second People's Hospital of Nanning,Nanning 530000,China)
出处
《广西医学》
CAS
2018年第23期2782-2785,共4页
Guangxi Medical Journal
基金
广西医药卫生科研课题(Z20170117)
关键词
新生儿呼吸窘迫综合征
多索茶碱
双水平正压通气
Neonatal respiratory distress syndrome
Doxofylline
Bi-level positive airway pressure
