免疫球蛋白联合经鼻持续气道正压通气治疗新生儿急性肺损伤的疗效

Efficacy of immunoglobulin combined with nasal continuous positive airway pressure ventilation for treatment of neonatal acute lung injury

目的探讨免疫球蛋白联合经鼻持续气道正压通气(NCPAP)治疗新生儿急性肺损伤(ALI)的疗效。方法将218例ALI新生儿随机分为对照组和研究组各109例。两组均给予NCPAP治疗,研究组同时给予免疫球蛋白治疗。比较两组机械通气时间、住院时间、炎症因子水平、血气分析及并发症发生情况。结果研究组机械通气时间、住院时间短于对照组(均P<0.05)。治疗1 d及2 d后研究组白细胞介素(IL)6、肿瘤坏死因子-α、PaCO 2水平均低于治疗前及对照组,而IL-10、PaO 2、PaO 2/吸入氧浓度比值均高于治疗前及对照组(均P<0.05)。两组患儿并发症发生率比较差异无统计学意义(P>0.05)。结论与单纯NCPAP治疗相比,免疫球蛋白联合NCPAP治疗,可更好地减轻ALI新生儿机体炎性损伤,改善血气分析指标,缩短恢复时间,且不增加并发症发生率。

Objective To investigate the efficacy of immunoglobulin combined with nasal continuous positive airway pressure ventilation(NCPAP)for the treatment of acute lung injury(ALI)in neonates.Methods A total of 218 neonates with ALI were randomly divided into control group(n=109)and study group(n=109).Both groups were treated with NCPAP,besides,the study group was administered immunoglobulin.Duration of mechanical ventilation,hospital stay,inflammatory factors levels,blood gas analysis indicators and incidence of complications were compared between the two groups.Results The duration of mechanical ventilation and hospital stay in the study group were shorter than those in the control group(all P<0.05).After 1 and 2 days of treatment,the study group obtained lower levels of interleukin 6,tumor necrosis factorαand PaCO 2,higher levels of interleukin 10 and PaO 2,and a higher ratio of PaO 2/fraction of inspired oxygen as compared with the pre-treatment and the control group(all P<0.05).There was no significant difference in incidence rate of complications between the two groups(P>0.05).Conclusion Compared with NCPAP therapy alone,immunoglobulin combined with NCPAP therapy can better alleviate body inflammatory injury,improve blood gas analysis indicators and shorten recovery duration in ALI neonates without increasing the incidence rate of complications.