经鼻双水平正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效及对氧合功能的影响  

Effect of nasal double level positive pressure surfactant pulmonary on respiratory neonatal distress syndrome with combined ventilation and its effect on oxygenation

作　　者：王林娜 张矿召 张靖辉 WANG Lin-na;ZHANG Kuang-zhao;ZHANG Jing-hui(Department of Pediatrics,the First People's Hospital of Pingdingshan,Pingdingshan,Henan 467000,China)

机构地区：[1]平顶山市第一人民医院儿科,河南平顶山467000

出　　处：《医药论坛杂志》2024年第23期2489-2492,2497,共5页Journal of Medical Forum

摘　　要：目的探究针对罹患呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的新生儿经鼻双水平正压通气联合肺表面活性物质的疗效及其对氧合功能的影响。方法回顾性分析2021年8月—2023年10月平顶山市第一人民医院收治的136例NRDS患儿,在常规治疗基础上,将行经鼻双水平正压通气治疗的68例作为对照组,将添加肺表面活性物质治疗的68例作为观察组。观察比较两组治疗后血气指标、呼吸功能相关者指标及氧合指数。结果两组治疗前动脉血二氧化碳分压(partialpressure ofcarbon dioxideinartery,PaCO_(2))、血氧饱和度(blood oxygen saturation,SaO_(2))、动脉血氧分压(partial pressure of oxygen inartery,PaO_(2))水平比较,差异无统计学意义(P>0.05),观察组治疗后PaO_(2)及SaO_(2)水平为(86.35±5.68)mmHg及(95.62±2.64)mmHg,高于对照组,差异有统计学意义(P<0.05),PaCO_(2)水平(36.97±4.03)mmHg低于对照组的(41.19±4.22)mmHg,差异有统计学意义(P<0.05);两组治疗前平均动脉压(mean arterial pressure,MAP)、吸气峰压(peak inspiratory pressure,PIP)、呼气末正压(positive end-expiratory pressure,PEEP)水平比较,差异无统计学意义(P>0.05),观察组治疗后MAP、PIP、PEEP水平为(8.33±1.24)cmH_(2)O、(17.14±2.73)cmH_(2)O及(4.22±0.70)cmH_(2)O,均低于对照组,差异有统计学意义(P<0.05);氧合功能层面,观察组氧合指数(268.41±15.62)mmHg高于对照组(200.07±14.24)mmHg,差异具有统计学意义(P<0.05)。结论针对罹患NRDS的新生儿,肺表面活性物质联合经鼻双水平正压通气治疗对患儿氧合功能改善明显,临床推广价值较高。Objective To explore the efficacy and oxygenation effects of nasal positive pressure ventilation in Neonatal patients with respiratory distress syndrome(NRDS)using pulmonary surfactant combined with neonatal positive pressure.Methods A retrospective analysis was conducted from August 2021 to October 2023A total of 136 children with NRDS admitted to the First People's Hospital of Pingdingshan were enrolled.On the basis of conventional treatment,the control group was treated with transnasal bi-level positive-pressure ventilation,and the observation group was treated with lung surface active substances.Observed and compared the blood gas index,respiratory function related index and oxygenation index of the two groups after treatment.Results The levels of PaCO_(2),PaO_(2)and SaO_(2)before treatment were compared between the two groups.The difference was not statistically significant(P>0.05).The levels of PaO_(2)and SaO_(2)in the observation group after treatment were(86.35±5.68)mmHg and(95.62±2.64)mmHg,which were higher than those in the control group,and the differences were statistically significant(P<0.05).The PaCO_(2)level of the control group was(36.97±4.03)mmHg,which was lower than(41.19±4.22)mmHg of the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in MAP,PIP and PEEP levels between the two groups before treatment(P>0.05).The levels of MAP,PIP and PEEP in the observation group after treatment were(8.33±1.24)cmH_(2)O,(17.14±2.73)cmH_(2)O and(4.22±0.70)cmH_(2)O,which were lower than those in the control group,and the differences were statistically significant(P<0.05);In terms of oxygenation function,the oxygenation index of the observation group(268.41±15.62)mmHg was higher than that of the control group(200.07±14.24)mmHg,and the difference was statistically significant(P<0.05).Conclusion For neonates with NRDS,pulmonary surfactant combined with nasal bi-level positive pressure ventilation can significantly improve oxygenation

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

分 类 号：R722[医药卫生—儿科]