不同浓度一氧化氮对新生儿胎粪吸入综合征的应用  

Application of different concentrations of nitric oxide in the newborns with meconium aspiration syndrome

作　　者：马蕊 刘镇豪 MA Rui;LIU Zhenhao(Neonatal Intensive Care Unit,Shangqiu 476000,China;ICU,the First People's Hospital of Shangqiu City,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院新生儿重症监护室,商丘476000 [2]商丘市第一人民医院ICU,商丘476000

出　　处：《华夏医学》2025年第1期138-143,共6页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ202101202)。

摘　　要：目的观察不同浓度一氧化氮(NO)对新生儿胎粪吸入综合征(MAS)氧合功能及炎症因子的影响。方法选取90例MAS患儿,按照随机数字表法分为低浓度组和常规组,每组45例。低浓度组予以吸入低浓度NO,常规组予以吸入常规浓度NO,比较两组患者的氧合功能、炎症反应、凝血功能及NO相关不良反应发生情况。结果在不同治疗方案下,低浓度组的动脉血氧含量(CaO_(2))、动脉氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、氧合指数与常规组比较,差异无统计学意义(P>0.05);低浓度组的肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平均低于常规组,差异具有统计学意义(P<0.05);低浓度组的凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均短于常规组,纤维蛋白原(FIB)水平高于常规组(P<0.05);低浓度组NO相关不良反应发生率为4.44%(2/45),低于常规组的22.22%(10/45)(P<0.05)。结论吸入低浓度NO对MAS患儿氧合功能的改善效果与常规浓度NO近似,但低浓度NO更有利于减轻患儿炎症反应、稳定凝血功能,并降低患儿并发症发生风险。Objective To observe the effects of different concentrations of nitric oxide(NO)on the oxygenation function and the inflammatory factors in the newborns with meconium aspiration syndrome(MAS).Methods 90 children with MAS were selected and were randomly divide into the low concentration group and the conventional group,with 45 cases in each group.The newborns in the low concentration group were given low concentration NO inhalation,while the newborns in the conventional group were given conventional concentration NO.The oxygenation function,inflammatory response,coagulation function,and incidence of NO related side effects were compared between the two groups newborns.Results There was no statistically significant difference in arterial oxygen content(CaO_(2)),arterial oxygen partial pressure(PaO_(2)),arterial oxygen saturation(SaO_(2)),and oxygenation index(arterial oxygen partial pressure/inhaled oxygen concentration,PO_(2)/FiO_(2))between the low concentration group and the conventional group(P>0.05).The levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),and interleukin-10(IL-10)in the low concentration group were lower than those in the control group(P<0.05).The prothrombin time(PT),thrombin time(TT),and activated partial thromboplastin time(APTT)in the low concentration group were lower than those in the conventional group,while fibrinogen(FIB)in the low concentration group was higher than that om the conventional group(P<0.05).The incidence of NO related side effects in the low concentration group was 4.44[FGS]%[FGN](2/45),which was lower than 22.22[FGS]%[FGN]in the conventional group(10/45)(P<0.05).Conclusion The improvement effect of inhaling low concentration NO on oxygenation function in the newborns with MAS is similar to that of conventional concentration NO,and low concentration NO is more conducive to reducing the inflammation,stabilizing the coagulation function,and reducing the risk of complications in newborn.

关 键 词：新生儿胎粪吸入综合征 一氧化氮 氧合功能 炎症因子 凝血功能 

分 类 号：R722[医药卫生—儿科]