吸入一氧化氮联合nCPAP治疗55例早期重症呼吸衰竭新生儿的疗效观察  

Clinical effect of iNO combined with nCPAP in the treatment of early severe neonatal respiratory failure

作　　者：张磊[1] 刘倩[2] 张小婷 Zhang Lei;Liu Qian;Zhang Xiaoting(Department of Neonatology,Zaozhuang Maternal and Child Health Hospital,Zaozhuang 277100,China;Department of Child Health,Zaozhuang Maternal and Child Health Hospital,Zaozhuang 277100,China)

机构地区：[1]枣庄市妇幼保健院新生儿科,277100 [2]枣庄市妇幼保健院儿童保健科,277100

出　　处：《国际呼吸杂志》2020年第17期1323-1328,共6页International Journal of Respiration

摘　　要：目的分析吸入一氧化氮(iNO)联合经鼻持续气道正压通气(nCPAP)治疗早期重症新生儿呼吸衰竭的临床效果及相关指标的影响。方法选取枣庄市妇幼保健院2016年2月至2020年2月收治的105例早期重症呼吸衰竭患儿进行研究,按照治疗方式将其分为研究组和对照组。对照组采用nCPAP进行治疗,研究组在此基础上联合iNO进行治疗;比较2组患儿治疗前后的血气指数与呼吸功能、相关临床指标与并发症的情况。结果2组患者治疗前呼吸功能和血气指数对比差异均无统计学意义(P值均>0.05),治疗后研究组患者的pH、动脉血二氧化碳分压、动脉血氧分压、平均动脉压、动脉肺泡氧分压比值以及肺动脉压显著优于对照组,差异均有统计学意义(t=9.199、12.316、13.748、4.293、4.387、5.178,P值均<0.05);研究组患儿治疗后nCPAP时间、新生儿重症监护中心时间及费用、总住院时间及费用均优于研究组,差异均有统计学意义(t=4.230、6.424、5.010、6.824、5.602,P值均<0.05);2组患儿治疗前后并发症比较,差异均无统计学意义(P值均>0.05);研究组患儿在使用iNO治疗40 min、4 h、24 h后,吸氧分数显著下降、血氧饱和指数显著升高、氧合指数明显降低(t=2.284、122.628、78.191,P值均<0.05)。结论iNO联合nCPAP治疗早期重症新生儿呼吸衰竭疗效显著,安全系数较高,值得临床推荐使用。Objective To analyze the clinical effect of inhaling nitric oxide (iNO) in combination with nasal continuous positive airway pressure (nCPAP) in the treatment of early severe neonatal respiratory failure and the influence of related indexes.Methods A total of 105 children with early severe respiratory failure admitted to Zaozhuang Maternity and Child Health Hospital from February 2016 to February 2020 for research were selected, and divided into a study group and a control group according to treatment methods.The control group was treated with nCPAP, and the observation group was treated with iNO on this basis;the blood gas index, respiratory function, related clinical indicators and complications of the two groups before and after treatment were compared.Results There was no significant difference in respiratory function and blood gas index between the two groups before treatment (all P>0.05). After treatment, pH, arterial carbon dioxide partial pressure, arterial oxygen partial pressure, manifold absolute pressure, alveolar oxygen partial pressure ratio/arterial and pulmonary artery pressure in the study group were significantly better than those in the control group (t=9.199, 12.316, 13.748, 4.293, 4.387, 5.178, all P<0.05). NCPAP time, NICU time and cost, total length of stay and cost of the study group were better than those of the study group (t=4.230, 6.424, 5.010, 6.824, 5.602, all P<0.05). There was no significant difference in complications between the two groups before and after treatment(all P>0.05). The study group was treated with iNO for 40 min, 4 h, 24 h after, FiO2 decreased significantly, SpO2 increased and oxygenation index decreased significantly (t=2.284, 122.628, 78.191, all P<0.05).Conclusions The efficacy of iNO combined with nCPAP in the treatment of early severe neonatal respiratory failure is obvious, and the safety factor is high, which is worth clinical recommendation.

关 键 词：一氧化氮 经鼻持续气道正压通气 重症新生儿呼吸衰竭 

分 类 号：R722.1[医药卫生—儿科]