无创高频震荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的临床研究

Clinical study of non-invasive high frequency oscillatory ventilation combined with pulmonary surfactant in treatment of neonates with neonatal respiratory distress syndrome

  • 摘要: 目的 探讨无创高频震荡通气(NHFOV)联合肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征的临床效果。 方法 选取60例新生儿呼吸窘迫综合征患儿,随机分为对照组与观察组各30例。对照组采用无创间歇正压通气(NIPPV)联合PS治疗,观察组采用NHFOV联合PS治疗。比较2组患儿的治疗效果、平均动脉压(MAP)、动脉血氧分压[p(O2)]、动脉血二氧化碳分压[p(CO2)]、吸入气中的氧浓度分数(FiO2)、氧合指数(OI)及并发症发生情况。 结果 观察组总有效率为90.0%, 显著高于对照组的70.0%(P<0.05)。治疗后,观察组的p(O2)水平高于对照组, MAP、p(CO2)、FiO2、OI水平低于对照组,差异均有统计学意义(P<0.05)。2组患儿肺炎、气胸、肺出血等并发症发生率比较无显著差异(P>0.05)。 结论 NHFOV联合PS治疗新生儿呼吸窘迫综合征效果显著,可明显改善动脉血气指标,且不会增加并发症发生率。

     

    Abstract: Objective To explore the effect of non-invasive high frequency oscillatory ventilation(NHFOV)combined with pulmonary surfactant(PS)in the treatment of neonates with neonatal respiratory distress syndrome. Methods A total of 60 neonates with neonatal respiratory distress syndrome were selected and randomly divided into control group(n=30)and observation group(n=30). The control group was treated with non-invasive positive pressure ventilation(NIPPV)and PS, while the observation group was treated with NHFOV and PS. The therapeutic effect, mean arterial pressure(MAP), arterial oxygen partial pressure [p(O2)], arterial carbon dioxide partial pressure [p(CO2)], fraction of inspiration O2(FiO2), oxygenation index(OI)and complications were compared between the two groups. Results The total effective rate of the observation group was 90.0%, which was significantly higher than 70.0% of the control group(P<0.05). After treatment, the p(O2)level of the observation group was significantly higher than that of the control group, and the MAP, p(CO2), FiO2 and OI levels of the observation group were significantly lower than the control group(P<0.05). There were no significant differences in the incidence rates of pneumonia, pneumothorax and pulmonary hemorrhage between the two groups(P>0.05). Conclusion NHFOV combined with PS shows a significant effect in the treatment of neonates with neonatal respiratory distress syndrome, which can significantly improve the arterial blood gas indexes without increasing the incidence of complications.

     

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