固尔苏联合鼻塞式气道正压通气治疗新生儿呼吸窘迫综合征及对患者炎症因子的影响

Curosurf combined with nasal continuous positive airway pressure ventilation in treatment of neonatal respiratory distress syndrome and the effect on inflammatory factors

目的探讨固尔苏联合鼻塞式气道正压通气治疗新生儿呼吸窘迫综合征的疗效及对患者炎症因子的影响。方法选取2012年1月~2014年12月在该院就诊的新生儿呼吸窘迫综合征患者106例为研究对象,随机分成对照组和观察组,每组各53例。对照组接受常规治疗同时应用鼻塞式气道正压通气治疗,观察组接受常规治疗同时应用固尔苏联合鼻塞式气道正压通气治疗。结果观察组总有效率（92.45%）高于对照组（77.36%）,差异有统计学意义（P〈0.05）。治疗后,观察组患者Pa CO2水平低于对照组,Pa O2水平高于对照组,差异均有统计学意义（P均〈0.05）。治疗8、24、48、72 h后,观察组患者TNF-α、SF水平均低于对照组,IL-10水平均高于对照组,差异均有统计学意义（P〈0.05）。观察组患者的呼吸机相关性肺炎、颅脑出血、肺出血以及动脉导管未闭并发症的发生率与对照组比较,差异均无统计学意义（P〉0.05）。结论固尔苏联合鼻塞式气道正压通气治疗新生儿呼吸窘迫综合征疗效显著,能够有效改善血气指标、减轻患者的炎症反应。

Objective To explore the curative effect of Curosurf combined with nasal continuous positive airway pressure ventilation in treatment of neonatal respiratory distress syndrome and the effect on inflammatory factors. Methods A total of 106 cases with neonatal respiratory distress syndrome were selected from the hospital from January 2012 to December 2014 and randomly divided into control group and observation group,53 cases in each group. The cases in control group received routine treatment combined with nasal continuous positive airway pressure therapy,while the cases in observation group received routine treatment,Curosurf combined with nasal continuous positive airway pressure therapy. Results The total effective rate in observation group was 92. 45%,which was statistically significantly higher than that in control group（ 77. 36%）（ P〈0. 05）. After treatment,Pa CO2 level in observation group was lower than that in control group,while Pa O2 level in observation group was higher than that in control group,there were statistically significant differences（ P〈0. 05）. At 8,24,48,and 72 hours after treatment,tumor necrosis factor- α（ TNF- α） and SF levels in observation group were lower than those in control group,while IL- 10 level in observation group was higher than that in control group,there were statistically significant differences（ P〈0. 05）. There was no statistically significant difference in the incidence rates of ventilator associated pneumonia,cerebral hemorrhage,pulmonary hemorrhage,and patent ductus arteriosus between the two groups（ P〈0. 05）. Conclusion The curative effect of Curosurf combined with nasal continuous positive airway pressure ventilation in treatment of neonatal respiratory distress syndrome is significant,the method can effectively improve the blood gas indexes and relieve inflammation reaction.