持续气道正压通气联合不同肺表面活性物质治疗新生儿呼吸窘迫综合征的临床疗效

The Clinical Efficiency of Continuous Positive Airway Pressure the Joint different pulmonary Surfactant Treatment of Neonatal Respiratory Distress Syndrome

目的比较持续气道正压通气联合不同肺表面活性物质治疗新生儿呼吸窘迫综合征的临床疗效。方法将140例新生儿呼吸窘迫综合征患者,根据使用肺表面活性物质种类的不同分为对照组(牛肺表面活性物质)和观察组(猪肺表面活性物质),两组患者均给予持续气道正压通气(CPAP)呼吸支持治疗,比较两组患儿治疗前与治疗后12 h、24 h血气指标、CPAP持续时间及给氧时间、患儿心率、呼吸频率、平均氧合指数等体征、住院时间、总有效率及并发症发生情况。结果两组患者治疗前Pa O2、Pa CO2、p H值比较,P>0.05。对照组患者治疗12 h后与治疗前Pa O2、Pa CO2、p H值比较,P<0.01;治疗24 h后与治疗前Pa O2、Pa CO2、p H值比较,P<0.01。观察组患者治疗12 h后与治疗前Pa O2、PaCO2、p H值比较,P<0.01;治疗24 h后与治疗前Pa O2、Pa CO2、p H值比较,P<0.01。两组患儿治疗12 h后、24 h后Pa O2、Pa CO2、p H值比较,P>0.05。两组患儿治疗后心率、呼吸频率、平均氧合指数比较,P<0.001。两组患儿CPAP持续时间、给氧时间、住院时间比较,P<0.01。两组患儿治疗有效率和并发症发生率比较,P<0.05。结论采用CPAP联合猪肺表面活性物质可以更加经济有效地改善呼吸窘迫综合征患儿临床症状,提高了疗效,降低了并发症的发生率。

Objective To compare the clinical efficacy of continuous positive airway pressure ventilation with differ- ent pulmonary surfactants in the treatment of neonatal respiratory distress syndrome. Methods We retrospectively analyzed 140 patients with neonatal respiratory distress syndrome who were admitted to our department of pediatrics from June 2014 to June 2017. They were divided into control groups （bovine pulmonary surfactant） according to the type of pulmonary sur- factant used. In the observation group （porcine lung surfactant）, continuous positive airway pressure （CPAP） respiratory sup- port was given to both groups of patients. Blood gas parameters, CPAP duration, and oxygenation were compared between the two groups before and after treatment. Time, heart rate, respiratory rate, mean oxygenation index and other signs, length of hospital stay, total hospitalization costs, total effective rate, and complications. Results The PaO2, PaCO2 and pH values of the two groups were compared before treatment （P〉0.05）; PaO2, PaCO2 and pH values of the control group were compared after treatment for 12 h and before treatment （P〈0.01）; PaO2 was treated after the treatment for 24 h and before the treatment of the control group. PaCO2, pH value comparison, P〈0.01; PaO2, PaCO2 and pH value of the observation group patients after treatment for 12 h and before treatment, P〈0.01; PaO2, PaCO2 and pH value of the observation group patients after treatment for 24 h and before treatment, P〈0.01. The PaO2, PaCO2 and pH values were compared between the two groups after 12 h and 24 h after treatment, P〉0.05. The heart rate, respiratory rate, and mean oxygenation index of the two groups after treatment were compared, P〈0.001. CPAP duration, aerobic time, length of stay, and total hospital stay in the two groups were compared, P〈0.01. The treatment efficiency and complication rate in the two groups were compared, P〈0.05. Conclusion The use of CPAP in combination with swine lung surfactant can more effectively and economically improve the clinical symptoms of children with respiratory distress syndrome, improve treatment efficiency, and reduce the incidence of complications.