固尔苏气管内滴注对新生儿呼吸窘迫综合征患儿右心功能的影响

Influence of intratracheal instillation of curosurf on right ventricular function in neonatal respiratory distress syndrome

目的分析固尔苏气管内滴注治疗新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)对患儿右心功能的影响。方法回顾性选择在浙江省杭州市儿童医院儿科受诊的NRDS患者52例,依照治疗方式的不同,分为2组,常规组以鼻塞式气道通气治疗;固尔苏组基于常规组,加用固尔苏,各26例。比较2组治疗前后血气指标(Pa CO2、Pa O2、p H值),炎性反应(TNF-α、IL-10)、SF,统计并发症以及疗效。结果 2组p H值在各个时间节点比较无统计学差异,固尔苏组治疗后不同时间点Pa O2表达水平均明显高于常规组(P<0.05),Pa CO2表达水平均明显低于常规组(P<0.05)。治疗后不同时间点固尔苏组TNF-α、IL-10变化水平较常规组稳定(P<0.05),固尔苏组不同时间节点SF上升幅度更大(P<0.05)。固尔苏组总有效率80.77%明显高于常规组61.54%(P<0.05)。固尔苏组总并发症率19.24%与常规组23.08%无统计学差异。结论气管内滴注固尔苏治疗NRDS具有操作简便、副作用小、血气指标及炎性因子恢复快等优点,是临床治疗NRDS可行性较高的方案。

Objective To investigate the effect of intratracheal instillation of curosurf on neonatal respiratory distress syndrome（ NRDS） in children with right ventricular function. Methods 52 patients with NRDS were retrospectively selected and divided into two groups according to different treatment. The patients in the conventional group were treated with nasal airway ventilation. Based on the conventional group,the curosurf group was taken with curosurf. 26 cases were in each group. The blood gas index（ Pa CO2,Pa O2,p H）,inflammatory reaction（ TNF-α,IL-10）,SF of the two groups were compared,the complications and curative effect of the two groups before and after treatment were taken for statistics. Results There was no significant difference in p H value between the two groups at each time point. The Pa O2 expression levels in the curosurf group at different time points after treatment were significantly lower than the conventional group（ P〈0. 05）. The levels of TNF-α and IL-10 in the curosurf group were more stable than those in the control group at different time points after treatment（ P〈0. 05）,and the degree of SF increasing at different time points were higher（ P〈0. 05）. The total effective rate 80. 77% of the curosurf group was significantly higher than that of the conventional group 61. 54%（ P〈0. 05）. The total complication rate 19. 24% had no significant differences with the conventional group 23. 08%. Conclusion Intratracheal instillation of Cs A in the treatment of NRDS has the advantages of simple operation,little side effect,rapid recovery of blood gas index and inflammatory factors,so it is a feasible method for clinical treatment of NRDS.