不同机械通气方式联合猪肺磷脂注射液治疗新生儿呼吸衰竭疗效比较  

Comparison of the efficacy of different mechanical ventilation combined with porcine lung phospholipid injection in the treatment of neonatal respiratory failure

作　　者：赵杰 朱萍[1] 苌俊明 别静洋[1] 李德亮[1] 王海云 杨柳[1] ZHAO Jie;ZHU Ping;CHANG Junming;BIE Jingyang;LI Deliang;WANG Haiyun;YANG Liu(Neonatal Intensive Care Unit,Nanyang Central Hospital,Nanyang 473005,Henan Province,China)

机构地区：[1]南阳市中心医院新生儿重症监护病区,河南南阳473005

出　　处：《新乡医学院学报》2023年第1期67-72,共6页Journal of Xinxiang Medical University

摘　　要：目的比较常频机械通气(CMV)、猪肺磷脂注射液联合CMV、猪肺磷脂注射液联合高频振荡通气(HFOV)治疗新生儿呼吸衰竭的疗效。方法选择2019年1月至2020年12月南阳市中心医院收治的133例呼吸衰竭新生儿为研究对象,根据治疗方式将患儿分为对照组(n=41)、观察组A(n=45)和观察组B(n=47)。对照组患儿给予单纯CMV治疗,观察组A患儿给予猪肺磷脂注射液联合HFOV治疗,观察组B患儿给予猪肺磷脂注射液联合CMV治疗。比较3组患儿机械通气时间、用氧时间、治疗前后的呼吸力学指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)、呼吸指数(RI)]和血清内皮素-1(ET-1)、肌酸激酶同工酶(CK-MB)、Ⅱ型肺泡表面抗原-6(KL-6)、Clara细胞蛋白16(CC16)水平及不良反应发生情况。结果3组患儿的机械通气时间和用氧时间比较差异有统计学意义(F=12.658、26.196,P<0.05);观察组A和观察组B患儿的机械通气时间和用氧时间显著短于对照组(P<0.05),观察组A患儿的机械通气时间和用氧时间显著短于观察组B(P<0.05)。3组患儿治疗12、24、48、72 h的PaO_(2)显著高于治疗前,PaCO_(2)、RI、OI显著低于治疗前(P<0.05)。治疗12、24、48 h,观察组A和观察组B患儿的PaO_(2)显著高于对照组,观察组A患儿的PaO_(2)显著高于观察组B(P<0.05);治疗12、24、48 h,观察组A和观察组B患儿的PaCO_(2)显著低于对照组,观察组A患儿的PaCO_(2)显著低于观察组B(P<0.05);治疗12、24、48、72 h,观察组A和观察组B患儿的RI、OI显著低于对照组,观察组A患儿的RI、OI显著低于观察组B(P<0.05)。治疗前,3组患儿血清ET-1、CK-MB、KL-6、CC16比较差异均无统计学意义(P>0.05);3组患儿治疗72 h血清ET-1、CK-MB、KL-6、CC16显著低于治疗前(P<0.05);治疗72 h,观察组A和观察组B患儿血清ET-1、CK-MB、KL-6、CC16显著低于对照组,观察组A患儿血清ET-1、CK-MB、KL-6、CC16显著低于观察组B(P<0.05)�Objective To compare the efficacy of conventional mechanical ventilation(CMV),porcine lung phospholipid injection combined with CMV,porcine lung phospholipid injection combined with high-frequency oscillatory ventilation(HFOV)in the treatment of neonatal respiratory failure.Methods A total of 133 newborns with respiratory failure admitted to Nanyang Central Hospital from January 2019 to December 2020 were selected as the research objects,and the children were divided into the control group(n=41),observation group A(n=45)and observation group B(n=47)according to the different treatment methods.The children in the control group were given CMV treatment,the children in the observation group A were given porcine lung phospholipid injection combined with HFOV treatment,and the children in the observation group B were given porcine lung phospholipid injection combined with CMV treatment.The time of mechanical ventilation,time of oxygen use,the respiratory mechanics indexes[including the arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(OI)and respiratory index(RI)]and serum endothelin-1(ET-1),creatine kinase isoenzyme(CK-MB),krebs yon denlundgen-6(KL-6),Clara cell secretory protein 16(CC16)as well as the occurrence of adverse reactions of the children among the three groups were compared.Results There were significant difference in the time of mechanical ventilation and time of oxygen use of the children among the three groups(F=12.658,26.196;P<0.05);the time of mechanical ventilation and time of oxygen use of children in the observation group A and observation group B were significantly shorter than those in the control group(P<0.05),and the time of mechanical ventilation and time of oxygen use of children in the observation group A were significantly shorter than those in observation group B(P<0.05).At 12,24,48 and 72 hours of treatment,the PaO_(2) was significantly higher than that before treatment,and PaCO_(2),RI,OI were significantly lower than tho

关 键 词：猪肺磷脂注射液 常频机械通气 高频振荡通气 新生儿呼吸衰竭 

分 类 号：R722.1[医药卫生—儿科]