小潮气量机械通气治疗新生儿重症肺炎的疗效及对血清降钙素原、C-反应蛋白的影响

Effect of low tidal volume mechanical ventilation on neonatal severe pneumonia and its influence on serum procalcitonin and C-reactive protein

目的探讨小潮气量机械通气治疗新生儿重症肺炎的疗效及对血清降钙素原(PCT)、C-反应蛋白(CRP)水平的影响。方法纳入新生儿重症肺炎患儿68例,采用随机数字表法将其分为观察组和对照组,各34例。给予所有患儿常规对症治疗,其中观察组在对症治疗基础上予以小潮气量机械通气治疗,而对照组在对症治疗基础上予以常规潮气量机械通气治疗,对比两组患儿临床治疗效果。结果观察组治疗有效率高于对照组,组间差异显著(P<0.05);观察组上机24 h后PaO_(2)、pH值均高于对照组,PaCO_(2)低于对照组,组间差异显著(P<0.05);上机后两组血清PCT、CRP水平均显著改善,且观察组上机24 h后PCT与CRP水平低于对照组,组间差异显著(P<0.05);观察组不良事件发生率低于对照组,组间差异显著(P<0.05)。结论采用小潮气量治疗新生儿重症肺炎不仅可以促进患儿体征的消失,还有助于调节患儿的血气分析水平,抑制血清PCT,下调血清CRP水平,临床治疗优势显著。

Objective To investigate the effect of low tidal volume mechanical ventilation on neonatal severe pneumonia and its influence on serum procalcitonin(PCT)and C-reactive protein(CRP).Methods Sixty-eight children with severe pneumonia in children were enrolled,and they were divided into observation group and control group by random number table method,with 34 cases in each group.All children were given conventional symptomatic treatment.The observation group was treated with small tidal volume mechanical ventilation on the basis of symptomatic treatment,while the control group was treated with conventional tidal volume mechanical ventilation on the basis of symptomatic treatment.The clinical treatment effects of the two groups of children were compared.Results The effective rate of treatment in the observation group was higher than that in the control group,with significant difference between groups(P<0.05);The PaO_(2)and pH values in the observation group were higher than those in the control group 24 h after operation,and PaCO_(2)was lower than those in the control group,with significant difference between groups(P<0.05);The levels of serum PCT and CRP in the two groups were significantly improved after operation,and the levels of PCT and CRP in the observation group were lower than those in the control group 24 h after operation,with significant difference between the groups(P<0.05);The incidence of adverse events in the observation group was lower than that in the control group,with significant difference between groups(P<0.05).Conclusion The treatment of severe pneumonia in children with low tidal volume can not only promote the disappearance of the children's physical signs,but also help to regulate the children's blood gas analysis level,inhibit the high expression of serum PCT,and increase the serum TGF-βlevel.The clinical treatment advantage is significant.