HFOV模式下早期肺表面活性物质干预对呼吸窘迫综合征致重度呼吸衰竭患儿转归的影响  

The effect of early pulmonary surfactant intervention on the prognosis of severe respiratory failure in children with respiratory distress syndrome under HFOV mode

作　　者：王彬彬 张晋雷[1] 杨英阁[1] 王锦 孙颖 WANG Binbin;ZHANG Jinlei;YANG Yingge;WANG Jin;SUN Ying(Pediatric Ward One,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院儿科一病区,河南南阳473000

出　　处：《广州医药》2024年第11期1332-1337,1356,共7页Guangzhou Medical Journal

摘　　要：目的探究应用高频振荡通气(HFOV)模式下早期肺表面活性物质干预对呼吸窘迫综合征致重度呼吸衰竭患儿转归的影响。方法选取南阳医学高等专科学校第一附属医院2020年6月—2022年12月收治的120例呼吸窘迫综合征致重度呼吸衰竭患儿作为研究对象,按照随机数字表法将其分为对照组与研究组各60例,对照组行常规通气联合早期肺表面活性物质干预,研究组行HFOV联合早期肺表面活性物质干预,对比两组患儿临床症状、血气指标、肺功能指标、患儿转归分析、并发症以及临床疗效。结果研究组患儿症状消失时间为(31.28±10.24)h、呼吸机辅助通气时间为(50.13±15.81)h以及住院天数为(12.47±5.48)d,对照组患儿症状消失时间为(59.91±11.56)h,呼吸机辅助通气时间为(91.17±25.47)h及住院天数为(20.11±9.45)d,研究组低于对照组(P<0.05);治疗后,研究组患儿PaO_(2)为(77.89±9.10)mmHg,PaCO_(2)为(41.09±8.25)mmHg,氧合指数为(432.18±37.81)mmHg,对照组患儿PaO_(2)为(65.28±8.16)mmHg,PaCO_(2)为(49.71±8.91)mmHg,氧合指数为(258.64±56.74)mmHg,研究组PaO_(2)、氧合指数高于对照组,且PaCO_(2)低于对照组(P<0.05);治疗后,研究组患儿体重潮气量(TV)为(7.68±2.16)mL/kg,达峰容积比(TPEF/TE)为(34.19±4.06)%,达峰时间比(VPEF/VE)为(33.47±3.42)%,对照组患儿TV为(6.64±2.01)mL/kg,TPEF/TE为(28.66±3.81)%,VPEF/VE为(28.95±3.10)%,研究组高于对照组(P<0.05);研究组患儿支气管肺发育不良(BPD)为11.66%,对照组为13.33%,两组患儿BPD发生率比较差异无统计学意义(P>0.05);研究组IVH为3.33%、ROP为5.00,对照组脑室内出血(IVH)为8.33%,早产儿视网膜病(ROP)为11.66%,研究组低于对照组(P<0.05);研究组患儿并发症发生率为6.66%,对照组患儿并发症发生率为20.00%,研究组低于对照组(P<0.05);研究组患儿总有效率为96.66%,对照组患儿总有效率为83.33%,研究组高于对照组(P<0.05)。结论HFOV模式下早期肺表面活性Objective To investigate the effect of early intervention with pulmonary surfactant under HFOV mode on the outcome of severe respiratory failure in children with respiratory distress syndrome.Methods A total of 120 children with severe respiratory failure caused by respiratory distress syndrome admitted to our hospital from June 2020 to December 2022 were selected as the study subjects.They were randomly divided into a control group and a study group of 60 cases each using a random number table method.The control group received routine ventilation combined with early pulmonary surfactant intervention,while the study group received HFOV combined with early pulmonary surfactant intervention.Symptom disappearance,ventilator-assisted ventilation,hospital stay,blood gas indicators,lung function indicators,analysis of pediatric outcomes,complications,and clinical efficacy were compared between the two groups.Results The time of symptom disappearance was(31.28±10.24)h,the duration of ventilator assisted ventilation was(50.13±15.81)h and the number of days in hospital was(12.47±5.48)d in the study group,while the time of symptom disappearance was(59.91±11.56)h,the duration of ventilator assisted ventilation was(91.17±25.47)h and the number of days in hospital was(20.11±9.45)d in the control group,which were higher than those in the study group(P<0.05).After treatment,PaO_(2)was(77.89±9.10)mmHg,PaCO_(2)was(41.09±8.25)mmHg and oxygenation index was(432.18±37.81)mmHg in the study group,while PaO_(2)was(65.28±8.16)mmHg,PaCO_(2)was(49.71±8.91)mmHg and oxygenation index was(258.64±56.74)mmHg in the control group.The PaO_(2)and oxygenation index of the study group were higher than those of the control group,and the PaCO_(2)was lower than that of the control group(P<0.05).After treatment,TV in the study group was(7.68±2.16)mL/kg,TPEF/TE was(34.19±4.06)%,VPEF/VE was(33.47±3.42)%,and TV in the control group was(6.64±2.01)mL/kg,TPEF/TE was(28.66±3.81)%,VPEF/VE was(28.95±3.10)%.The study group was higher than the c

关 键 词：高频振荡通气 早期肺表面活性物质 呼吸窘迫综合征致重度呼吸衰竭 血气指标 

分 类 号：R725.6[医药卫生—儿科]