肺泡表面活性物质联合双水平正压通气治疗新生儿呼吸窘迫综合征的效果观察  

Effect of pulmonary surfactant combined with bilevel positive airway pressure on children with neonatal respiratory distress syndrome

作　　者：王岩[1] 齐玉敏[1] 任亚方 惠晓君 Wang Yan;Qi Yumin;Ren Yafang;Hui Xiaojun(Department of Neonates,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院新生儿科,南阳473000

出　　处：《中国实用医刊》2022年第15期60-63,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析肺泡表面活性物质(PS)联合双水平正压通气(BiPAP)治疗新生儿呼吸窘迫综合征(NRDS)的临床效果。方法抽取2018年1月至2021年4月南阳市中心医院收治的NRDS患儿150例,按随机数字表法分为PS组与BiPAP组,每组75例。BiPAP组采用BiPAP治疗,PS组在BiPAP基础上采用PS治疗。比较两组疗效、治疗情况、肺氧合功能参数、血气水平、通气指标及并发症发生率。结果PS组总有效率(94.67%,71/75)高于BiPAP组(80.00%,60/75),P<0.05;PS组机械通气、氧疗和住院时间均短于BiPAP组(P均<0.05)。治疗后,PS组动脉/肺泡氧分压比值、动脉血氧分压/吸入氧浓度、氧合指数、血浆二氧化碳总量、动脉血氧饱和度均高于BiPAP组,动脉血二氧化碳分压、呼气末正压、平均气道压力均低于BiPAP组(P均<0.05)。PS组并发症发生率(9.33%,7/75)低于BiPAP组(21.33%,16/75),P<0.05。结论PS联合BiPAP治疗NRDS患儿可改善肺氧合功能、血气水平、通气情况,加快患儿恢复,并可降低并发症发生风险,临床效果显著。Objective To analyze the application value of pulmonary surfactant(PS)combined with bilevel positive airway pressure(BiPAP)on pulmonary oxygenation parameters and complications in children with neonatal respiratory distress syndrome(NRDS).Methods A total of 150 children with NRDS treated in Nanyang Central Hospital from January 2018 to April 2021 were selected and divided into PS group and BiPAP group by random number table method,with 75 cases in each group.The BiPAP group was treated by BiPAP,and the PS group was treated by PS combined with BiPAP.The curative effect,treatment status,lung oxygenation function parameters,blood gas level,ventilation index,and complication rate were compared between the two groups.Results The total effective rate of the PS group was 94.67%(71/75),which was higher than the 80.00%(60/75)of the BiPAP group(P<0.05).The duration of mechanical ventilation,oxygen therapy and hospitalization in the PS group were shorter than those in the BiPAP group(all P<0.05).After treatment,the ratio of arterial/partial pressure of oxygen in alveolar gas,arterial partial pressure of oxygen/fraction of inspired oxygen,oxygen index,total carbon dioxide,arterial oxygen saturation in the PS group were higher than those in the BiPAP group(all P<0.05),and the levels of arterial partial pressure of carbon dioxide,positive end expiratory pressure,mean airway pressure were lower than those in the BiPAP group(all P<0.05).The incidence of complications in the PS group(9.33%,7/75)was lower than that in the BiPAP group(21.33%,16/75),P<0.05.Conclusions PS combined with BiPAP in the treatment of children with NRDS can improve lung oxygenation,blood gas levels and ventilation,speed up the recovery of children,and reduce the risk of complications.The clinical effect is significant.

关 键 词：新生儿呼吸窘迫综合征 肺泡表面活性物质 双水平正压通气 肺氧合功能 

分 类 号：R722.1[医药卫生—儿科]