联合应用PS、HFOV和iNO治疗新生儿重度呼吸衰竭的疗效观察  

Combined application of PS,HFOV and iNO in treatment of neonatal severe respiratory failure

作　　者：夏胜英[1] 王艳丽[1] 胡艳[1] 陈和斌[1] 

机构地区：[1]武汉市儿童医院呼吸内科,湖北武汉430015

出　　处：《中国妇幼健康研究》2017年第8期946-947,1029,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨联合应用肺表面活性物质(PS)、高频振荡通气(HFOV)、吸入一氧化氮(iNO)治疗新生儿重度呼吸衰竭的疗效。方法选取2013年2月至2016年2月间武汉市儿童医院新生儿重症监护室收治的86例重度呼吸衰竭新生儿,均采用PS、HFOV、iNO联合治疗。观察比较患儿治疗前后酸碱度(pH)、二氧化碳分压(PaCO_2)、氧分压(PaO_2)动脉血气分析指标,吸入氧浓度(FiO_2)、平均气道压(MAP)、氧合指数(OI)呼吸功能指标,并观察临床疗效及并发症发生情况。结果在86例患儿中,总有效率为76.7%(66/86),并发症的发生率为4.7%(4/86)。治疗前与治疗后1、6、24h患儿的pH、PaCO_2、PaO_2、FiO_2、MAP、OI比较差异均具有统计学意义(F值分别为19.064、63.158、42.790、62.163、17.737,38.944,均P<0.05);且与治疗前相比,治疗后1、6、24h患儿的pH、PaO_2均升高,PaCO_2、FiO_2、MAP、OI均下降,差异均具有统计学意义(t=-18.354~32.403,均P<0.05)。结论联合应用PS、HFOV和iNO治疗新生儿重度呼吸衰竭的疗效显著,可有效改善患儿的动脉血气分析指标和呼吸功能指标,值得应用推广于临床。Objective To investigate the curative effect of combined application of pulmonary surfactant（ PS）,high frequency oscillatory ventilation（ HFOV） and nitric oxide inhalation（ iNO） in treatment of neonatal severe respiratory failure. Methods Eighty-six neonates with severe respiratory failure admitted in neonatal intensive care unit of Wuhan Children＇s Hospital from February 2013 to February 2016 were selected. All patients were treated with combined application of PS,HFOV and iNO. Arterial blood gas analysis indicators including Pouvoir Hydrogène（ p H）,arterial blood carbon dioxide partial pressure（ Pa CO2） and alveolar oxygen partial pressure（ PaO2）,and respiratory function indicators including fraction of inspiration oxygen（ FiO2）,mean airway pressure（ MAP） and oxygenation index（ OI）were measured and compared before and after treatment. Besides,clinical curative effect and complications were observed. Results Total effective rate was 76. 7%（ 66/86） in 86 patients and incidence of complications was 4. 7%（ 4/86）. Differences in p H,Pa CO2,PaO2,FiO2,MAP and OI before treatment and in 1,6,24 h after treatment were significant（ F value was 19. 064,63. 158,42. 790,62. 163,17. 737 and 38. 944,respectively,all P〈0. 05）. Compared to those before treatment,in 1,6 and 24 h after treatment levels of p H and PaO2 of patients were increased,while levels of Pa CO2,FiO2,MAP and OI were all decreased,and differences had statistical significance（ t value ranged-18. 354 to 32. 403,all P〈0. 05）. Conclusion Curative effect of combined application of PS,HFOV and iNO in treatment of neonatal severe respiratory failure is significant. It can effectively improve arterial blood gas analysis indicators and respiratory function indicators of patients,and it is worthy of clinical application and promotion.

关 键 词：肺表面活性物质 高频振荡通气 一氧化氮 新生儿 重度呼吸衰竭 

分 类 号：R722.1[医药卫生—儿科]