新生儿呼吸窘迫综合征应用不同方法治疗的临床效果  

Clinical Effect of Different Treatment Methods on Neonatal Respiratory Distress Syndrome

作　　者：许燕颖 车伟坤 谢伯威 XU Yanying;CHE Weikun;XIE Bowei(Department of Neonatology,The People’s Hospital of Gaozhou,Gaozhou Guangdong 525200,China)

机构地区：[1]高州市人民医院新生儿科,广东高州525200

出　　处：《中国卫生标准管理》2021年第19期70-73,共4页China Health Standard Management

摘　　要：目的探究牛肺表面活性剂联合高频振荡通气(high frequency oscillatory ventilation,HFOV)与牛肺表面活性剂联合常频通气对新生儿呼吸窘迫综合征血气指数及安全性的影响。方法收集2019年1月1日—2020年9月30日在本院出生并确诊为呼吸窘迫综合征的新生儿100例,不限性别。随机将其分为牛肺表面活性剂联合高频震荡通气治疗组(高频组)和牛肺表面活性剂联合常频通气(常频组),每组50例。观察两组新生儿治疗近期各时段的二氧化碳分压(partial pressure of carbon dioxide,PaCO2)和氧合指数(oxygenation index,OI),机械通气时间、氧暴露时间,治疗后并发症发生率。结果高频组治疗后2 h,12 h,24 h OI及PaCO2均低于常频组,比较差异均有统计学意义(P<0.05);高频组机械通气时间(无创及有创)、氧暴露时间均低于常频组,比较差异均有统计学意义(P<0.05);两组患儿病死率比较无统计学意义(P>0.05);两组患儿并发症比较发现,高频组支气管肺发育不良(bronchopulmonary dysplasia,BPD)、脑室内出血(intraventricular hemorrhage,IVH)发生率(0%、0%)与常频组(4.00%、0%)比较差异无统计学意义(P>0.05),脑室周围白质软化(periventricular leukomalacia,PVL)、肺气漏发生率(0%、2.00%)均低于常频组(14.00%、16.00%),差异均有统计学意义(P<0.05)。结论HFOV联合牛肺表面活性剂较常频通气联合牛肺表面活性剂在血气指数、机械通气时间方面均存在优势,并在减少BPD和肺气漏发生方面更具有显著作用。Objective To compare the effects of calf pulmonary surfactant for injection plus high-frequency oscillation ventilation(HFOV)or calf pulmonary surfactant for injection plus conventional ventilation on the blood gas index and treatment safety of respiratory distress syndrome newborns.Methods 100 respiratory distress syndrome newborns from January 12019 to September 302020 treated in the hospital without the limitations of gender were reviewed and randomly assigned to high-frequency group and conventional group,50 cases in each group.Newborns were treated with calf pulmonary surfactant for injection plus HFOV(high-frequency group)or calf pulmonary surfactant for injection plus conventional ventilation(conventional group),respectively.At each time point,partial pressure of carbon dioxide(PaCO2),oxygenation index(OI),mechanical ventilation time,oxygen exposure duration and complication rate were explored.Results After 2 h,12 h and 24 h of treatment,OI and PaCO2 levels in high-frequency group were lower than conventional group,with statistically significant difference(P<0.05);mechanical ventilation time(non-invasive and invasive)and oxygen exposure duration in high-frequency group were shorter than conventional group,with statistically significant difference(P<0.05);case fatality rate between groups showed no statistically significant difference(P>0.05);compared the complications of two groups.There was no significant difference in the incidence of bronchopulmonary dysplasia(BPD)and intraventricular hemorrhage(IVH)(0%,0%)between the high-frequency group and the normal frequency group(4.00%,0%)(P>0.05).The incidence of periventricular leukomalacia(PVL)and pulmonary air leakage(0%,2.00%)were lower than those in the normal frequency group(14.00%,16.00%),and the differences were statistically significant(P<0.05).Conclusion HFOV combined with calf pulmonary surfactant for injection is proven to be more effective than conventional ventilation,which can improve the blood gas index,shorten the mechanical ventilation time and

关 键 词：新生儿呼吸窘迫综合征 牛肺表面活性剂 高频震荡机械 常频通气 血气指数 肺表面活性 安全性 

分 类 号：R722[医药卫生—儿科]