人免疫球蛋白联合机械通气策略在儿童重度肺源性急性呼吸窘迫综合征抢救中的应用  

Application of Human Immunoglobulin Combined with Mechanical Ventilation Strategy in the Rescue of Severe Pulmonary Acute Respiratory Distress Syndrome in Children

作　　者：经涛 吴优 徐凤琴 李小双 徐卫华 Jing Tao;Wu You;Xu Fengqin;Li Xiaoshuang;Xu Weihua(Anhui Children’s Hospital,Hefei 230051,China)

机构地区：[1]安徽省儿童医院,合肥230051

出　　处：《儿科药学杂志》2025年第3期24-27,共4页Journal of Pediatric Pharmacy

基　　金：安徽省自然科学基金面上项目,编号2108085MH268。

摘　　要：目的:探讨人免疫球蛋白联合机械通气策略在儿童重度肺源性急性呼吸窘迫综合征抢救中的应用。方法:选取2017-2022年安徽省儿童医院收治的40例重度肺源性急性呼吸窘迫综合征患儿,采用信封法分为对照组和观察组,由于中途死亡10例,最终完成本研究患儿30例。对照组14例采用机械通气进行治疗,观察组16例在对照组基础上给予人免疫球蛋白进行治疗。比较两组患儿机械通气时间、住院时间、血气指标、血清炎症因子、肺功能、并发症发生情况。结果:观察组机械通气时间和住院时间均短于对照组;pH、二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))、第1秒用力呼气容积(FEV1)、FEV1%、呼气峰值流速(PEF)治疗前后差值均大于对照组;治疗后白细胞介素(IL)-10水平均高于对照组,肿瘤坏死因子(TNF)-α、细胞间黏附分子-1(ICAM-1)、IL-6水平均低于对照组(P均<0.05)。两组患儿并发症总发生率比较差异无统计学意义(P>0.05)。结论:人免疫球蛋白联合机械通气策略用于儿童重度肺源性急性呼吸窘迫综合征抢救中可缩短治疗时间,更好地恢复肺功能,降低机体炎症反应,且不会加重不良反应的发生,值得临床推广应用。Objective:To explore the application of human immunoglobulin combined with mechanical ventilation strategy in the rescue of severe pulmonary acute respiratory distress syndrome in children.Methods:Forty children with severe pulmonary acute respiratory distress syndrome admitted into Anhui Children’s Hospital from 2017 to 2022 were extracted to be divided into the control group and observation group via the envelope method.As 10 cases died during the course,30 cases of children completed the research.Sixteen children in the control group were treated with mechanical ventilation,while 16 cases in the observation group received human immunoglobulin on the basis of the control group.The duration of mechanical ventilation,length of stay,blood gas indicators,serum inflammatory factors,lung function,and incidence of complications were compared between two groups.Results:The mechanical ventilation time and length of stay in the observation group were shorter than those in the control group.The differences of pH,partial pressure of carbon dioxide in artery(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),forced expiratory volume in one second(FEV1),FEV1%and peak expiratory flow(PEF)before and after treatment in the observation group were greater than those in the control group.After treatment,the levels of interleukin(IL)-10 in observation group were higher than those in control group,and the levels of tumour necrosises factor(TNF)-α,intercellular adhesion molecule-1(ICAM-1)and IL-6 were lower than those in control group(P<0.05).The total incidence of complications between two groups showed no statistically significant difference(P>0.05).Conclusion:The combination of human immunoglobulin and mechanical ventilation strategy in the rescue of severe pulmonary acute respiratory distress syndrome in children can shorten the treatment time,improve lung function recovery,and reduce the inflammatory response of the body,without increasing the occurrence of adverse drug reactions,which is worthy of clinical application.

关 键 词：人免疫球蛋白 机械通气 儿童 重度肺源性急性呼吸窘迫综合征 血气指标 肺功能 

分 类 号：R725.6[医药卫生—儿科]