珂立苏联合鼻塞持续气道正压通气治疗新生儿呼吸衰竭的临床分析

Clinical analysis of Kelisu combined with nasal continuous positive airway pressure ventilation for the treatment of neonatal respiratory failure

目的探讨注射用牛肺表面活性剂(商品名:珂立苏)联合鼻塞持续气道正压通气治疗新生儿呼吸衰竭的临床效果.方法 52例呼吸衰竭新生儿作为研究对象,依据治疗方式不同分为对照组(22例)与观察组(30例).对照组采用单纯的鼻塞持续气道正压通气治疗,观察组在对照组基础上联合珂立苏治疗.比较两组新生儿治疗前后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、吸入氧浓度(FiO2)、呼气末正压(PEEP)以及通气时间、氧疗时间、改有创机械通气情况.结果治疗前,两组新生儿PaO2、PaCO2、FiO2、PEEP比较差异无统计学意义(P>0.05);治疗后,两组新生儿PaCO2、FiO2、PEEP均低于本组治疗前,PaO2均高于本组治疗前,且观察组新生儿PaCO2、FiO2、PEEP低于对照组,PaO2高于对照组,差异均具有统计学意义(P<0.05).观察组新生儿通气时间(5.4±1.8)d、氧疗时间(4.4±1.6)d均明显短于对照组的(8.2±2.6)、(7.1±2.0)d,改有创机械通气率3.3%明显低于对照组的22.7%,差异均具有统计学意义(P<0.05).结论珂立苏联合鼻塞持续气道正压通气治疗新生儿呼吸衰竭,可使临床症状明显改善,效果良好.

Objective To discuss the clinical effect of calf pulmonary surfactant for injection(trade name: Kelisu) combined with nasal continuous positive airway pressure ventilation for the treatment of neonatal respiratory failure. Methods A total of 52 respiratory failure neonates as study subjects were divided by different treatment methods into control group(22 cases) and observation group(30 cases). The control group was treated with nasal continuous positive airway pressure ventilation, and the observation group was treated with Kelisu on the basis of the control group. Comparison was made on partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2), fraction of inspired oxygen(FiO2) and positive expiratory end pressure(PEEP) before and after treatment, as well as ventilation time, duration of oxygen therapy, change of invasive mechanical ventilation between the two groups. Results Before treatment, there was no statistically significant difference in PaO2, PaCO2, FiO2 and PEEP between the two groups(P>0.05). After treatment, both groups had lower PaO2, PaCO2, FiO2 and PEEP than those before treatment, and higher PaO2 than that before treatment. The observation group had lower PaCO2, FiO2, PEEP than those of the control group, and higher PaO2 than that of the control group. Their difference was statistically significant(P<0.05). The observation group had obviously shorter ventilation time as(5.4±1.8) d, duration of oxygen therapy as(4.4±1.6) d than(8.2±2.6) and(7.1±2.0) d in the control group, and obviously lower change rate of invasive mechanical ventilation as 3.3% than 22.7% in the control group. Their difference was statistically significant(P<0.05). Conclusion Kelisu combined with nasal continuous positive airway pressure ventilation can obviously improve the clinical symptom of neonatal respiratory failure, and its effect is good.