猪肺磷脂注射液气管内滴入+有创机械通气序贯治疗联合NHFOV或NCPAP应用于早产儿RDS的效果比较  

Comparison of effects of sequential treatment of porcine lung phospholipid injection intratracheal instillation+invasive mechanical ventilation combined with NHFOV or NCPAP in RDS in preterm infants

作　　者：张亚维 王颍源[1] 金娟[1] 李明超 ZHANG Yawei;WANG Yingyuan;JIN Juan;LI Mingchao(Neonatal Intensive Care Unit,Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital/Zhengzhou Children's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院新生儿重症监护病区,河南郑州450000

出　　处：《临床医学研究与实践》2021年第27期26-29,共4页Clinical Research and Practice

基　　金：河南省医学科技攻关计划项目(No.2018020673)。

摘　　要：目的比较猪肺磷脂注射液气管内滴入+有创机械通气序贯治疗联合无创高频振荡通气(NHFOV)或鼻塞式持续气道正压通气(NCPAP)应用于早产儿呼吸窘迫综合征(RDS)的临床效果。方法选取2019年1月至2020年10月在我院治疗的92例RDS早产儿作为研究对象,按照随机数字表法将其分为观察组与对照组,每组46例。入院后,两组患儿均采用猪肺磷脂注射液气管内滴入+有创机械通气序贯治疗,拔除气管插管后,观察组实施NHFOV,对照组实施NCPAP。比较两组的临床疗效,不同时间点的肺表面活性物质蛋白D(SP-D)、肺组织水通道蛋白5(AQP-5)水平、动脉血气指标[动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO_(2))]及并发症发生情况。结果观察组的治疗总有效率为97.83%,明显高于对照组的82.61%,差异具有统计学意义(P<0.05)。T_(0)、T_(1)时,两组的SP-D、AQP-5水平和PaCO2、PaO_(2)比较,差异无统计学意义(P>0.05);T_(2)~T_(4)时,观察组的SP-D、AQP-5水平及PaCO2明显低于对照组,PaO_(2)明显高于对照组(P<0.05);T_(0)~T_(4)时,两组的SP-D、AQP-5水平及PaO_(2)呈升高趋势,PaCO2呈下降趋势(P<0.05)。观察组的并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。结论猪肺磷脂注射液气管内滴入+有创机械通气序贯治疗联合NHFOV应用于早产儿RDS的效果显著,可有效降低SP-D、AQP-5水平,改善动脉血气指标,减少并发症的发生。Objective To compare the clinical effects of sequential treatment of porcine lung phospholipid injection intratracheal instillation + invasive mechanical ventilation combined with non-invasive high frequency oscillatory ventilation(NHFOV) or nasal continuous positive airway pressure(NCPAP) in respiratory distress syndrome(RDS) in preterm infants. Methods Ninety-two preterm infants with RDS treated in our hospital from January 2019 to October 2020 were selected as the study objects, and the infants were divided into observation group and control group according to random number table method, with 46 cases in each group. After admission, infants in both groups were given sequential treatment of porcine lung phospholipid injection intratracheal instillation + invasive mechanical ventilation.After tracheal intubation was removed, the observation group received NHFOV and the control group received NCPAP.The clinical efficacy, pulmonary surfactant protem-D(SP-D), pulmonary aquaporin-5(AQP-5) levels and arterial blood gas indexes [arterial partial pressure of carbon dioxide(PaCO2), arterial partial pressure of oxygen(PaO2)] at different times and complications of the two groups were compared. Results The total effective rate of treatment in the observation group was 97.83%, which was significantly higher than 82.61% in the control group, and the difference was statistically significant(P<0.05). At T0 and T1, there were no significant differences in the SP-D, AQP-5 levels, PaCO2 and PaO2 between the two groups(P >0.05);at T2-T4, the SP-D, AQP-5 levels and PaCO2 in the observation group were significantly lower than those in the control group, while PaO2 was significantly higher than that in the control group(P<0.05);at T0-T4, SP-D, AQP-5 levels and PaO2 in the two groups showed a increased trend, while PaCO2 showed a downward trend(P<0.05). The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant( P <0.05). Conclusion The seque

关 键 词：呼吸窘迫综合征 早产儿 无创高频振荡通气 鼻塞式持续气道正压通气 猪肺磷脂注射液 有创机械通气 动脉血气指标 

分 类 号：R72[医药卫生—儿科]