nSIMV配合肺泡表面活性物质对呼吸窘迫综合征早产儿血气状态及治疗效果的影响  

Effect of nSIMV combined with pulmonary surfactant on blood gas status and treatment effect in premature infants with respiratory distress syndrome

作　　者：蔡本龙 邓曼 刘彩霞[1] 杨敏[1] 谢集建[1] CAI Ben-long;DENG Man;LIU Cai-xia;YANG Min;XIE Ji-jian(Department of Pediatrics,Affiliated Taihe Hospital of Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院附属太和医院儿科,湖北十堰442000

出　　处：《热带医学杂志》2021年第6期735-739,共5页Journal of Tropical Medicine

基　　金：湖北省卫生计生委科研基金资助项目(WJ2018M062);十堰市太和医院院内资助项目(2017JJXM114)。

摘　　要：目的探讨鼻塞式同步间歇指令通气(n SIMV)配合肺泡表面活性物质(PS)对呼吸窘迫综合征(RDS)早产儿血气状态及治疗效果的影响。方法选取2017年10月-2019年8月湖北医药学院附属太和医院RDS早产儿104例,依据随机数字表法分为观察组和对照组,每组52例。对照组采取nSIMV,观察组于对照组基础上加用PS治疗,比较两组通气时间、氧疗时间及住院时间、临床疗效、治疗前后血气状态[动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、pH值]、氧合功能[呼吸指数(RI)、氧合指数(OI)、PaO_(2)/FiO_(2)]、肺功能[呼吸系统阻力(Rrs)、肺动态顺应性(Crs)]、并发症等指标。结果观察组通气时间、氧疗时间及住院时间明显短于对照组,差异有统计学意义(P<0.001);观察组总有效率94.23%(49/52),明显高于对照组78.85%(41/52),差异有统计学意义(χ^(2)=5.283,P=0.022)。两组治疗前PaO_(2)、p H值、PaCO_(2)、RI、OI、PaO_(2)/FiO_(2)、Rrs、Crs比较差异无统计学意义(P>0.05);治疗后,两组PaO_(2)、pH值、PaCO_(2)、RI、OI、PaO_(2)/FiO_(2)、Rrs、Crs较治疗前改善,且观察组治疗后PaO_(2)、pH值、PaO_(2)/FiO_(2)、Rrs、Crs明显高于对照组,PaCO_(2)、RI、OI明显低于对照组,差异均有统计学意义(P<0.05)。观察组气胸、感染、肺炎、肺出血、气漏发生率与对照组比较,差异无统计学意义(P>0.05)。结论 nSIMV配合PS初次治疗RDS早产儿,疗效确切,能有效缩短通气时间、氧疗时间及住院时间,改善血气分析,提升氧合功能,提高肺功能,保证安全性。Objective To investigate the effects of nasal synchronized intermittent mandatory ventilation(nSIMV)combined with pulmonary surfactant(PS)on blood gas status and treatment effect in preterm infants with respiratory distress syndrome(RDS). Methods A total of 104 premature infants with RDS in our hospital from October 2017 to August 2019 were selected and divided into observation group and control group according to the random number table method,with 52 cases each. The control group adopted nSIMV,and the observation group was supplemented with PS on the basis of the control group. The ventilation time,oxygen therapy time and hospital stay,clinical efficacy,blood gas status [partial pressure of carbon dioxide in artery(PaCO_(2)),partial pressure of oxygen in artery(PaO_(2)),pH value],oxygenation function[respiratory index(RI),oxygenation index(OI),PaO_(2)/FiO_(2)],lung function[resistance of the respiratory system(Rrs),compliance of the respiratory system(Crs)]before and after treatment,and complications were counted in the two groups.Results The ventilation time,oxygen therapy time and hospital stay of the observation group were significantly shorter than those of the control group,and the difference was statistically significant(P<0.001). The total effective rate of the observation group was 94.23%(49/52),which was significantly higher than that of the control group 78.85%(41/52)(χ^(2)=5.283,P=0.022). There was no significant difference in PaO_(2),p H,PaCO_(2),RI,OI,PaO_(2)/FiO_(2),Rrs,Crs between the two groups before treatment(P>0.05);PaO_(2),p H,PaO_(2)/FiO_(2),Rrs,Crs of the observation group after treatment were significantly higher than those of the control group,and the difference was statistically significant(P<0.05). PaCO_(2),RI,OI of the observation group were lower than those of the control group after treatment,the difference was statistically significant(P<0.05). There were no significant differences in the incidence of pneumothorax,infection,pneumonia,pulmonary hemorrhage,and air leak between the o

关 键 词：鼻塞式同步间歇指令通气 肺泡表面活性物质 呼吸窘迫综合征 血气状态 氧合功能 

分 类 号：R725.6[医药卫生—儿科]