猪肺磷脂注射液联合高频振荡通气治疗新生儿呼吸衰竭的临床研究

Clinical study on Poractant Alfa Injection combined with high frequency oscillatory ventilation in treatment of neonatal respiratory failure

目的研究猪肺磷脂联合高频振荡通气(HFOV)治疗新生儿呼吸衰竭的临床疗效。方法选取2018年4月—2019年12月河南科技大学第一附属医院收治的呼吸衰竭新生儿80例,随机分为对照组和治疗组,每组各40例。对照组给予HFOV治疗,治疗组在对照组的基础上气管内插管滴注猪肺磷脂注射液,200 mg/kg。两组患儿均连续治疗3 d,或患儿临床症状好转、血气分析结果正常结束治疗。观察两组患者临床疗效,同时比较治疗前后两组患儿血气指标、血清热休克蛋白70(HSP70)水平、硫化氢(H2S)水平和不良反应。结果治疗后,对照组临床总有效率为80.00%,显著低于治疗组的95.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患儿动脉氧分压(pO2)、血氧饱和度(SaO2)、动脉二氧化碳分压(pO2)/氧体积分数(FiO2)显著升高(P<0.05),pCO2、氧合指数(OI)、呼吸指数(RI)显著下降(P<0.05);且治疗组治疗后血气指标明显好于对照组(P<0.05)。治疗后,两组患儿HSP70和H2S水平显著降低(P<0.05),且治疗组比对照组更低(P<0.05)。对照组不良反应总发生率为47.50%,治疗组总发生率为25.00%,两组比较差异具有统计学差异(P<0.05)。结论猪肺磷脂联合HFOV可进一步提高新生儿呼吸衰竭的临床疗效,改善患儿的肺氧合功能,降低血清HSP70和H2S,扭转机体的缺氧状态。

Objective To investigate the effect of Poractant Alfa Injection combined with high frequency oscillatory ventilation in treatment of neonatal respiratory failure.Methods Children(80 cases)with respiratory failure in the First Affiliated Hospital of Henan University of Science and Technology from April 2018 to December 2019 were randomly divided into control and treatment groups,and each group had 40 cases.Children in the control group were administered with high frequency oscillatory ventilation.Children in the treatment group were endotracheal intubation infusion administered with Poractant Alfa Injection on the basis of the control group,200 mg/kg.Children in two groups were treated for 3 d,or until the clinical symptoms improved and blood gas analysis results were normal.After treatment,the clinical efficacy was evaluated,and the blood gas indexes,the serum levels of HSP70 and H2S,the adverse reactions in two groups before and after treatment were compared.Results After treatment,the clinical efficacy in the control group was 80.00%,which was significantly lower than 95.00%in the treatment group,and there were differences between two groups(P<0.05).After treatment,the pO2,SaO2,and pO2/FiO2 in two groups were significantly increased(P<0.05),but the pCO2,OI,and RI in two groups were significantly decreased(P<0.05),and the blood gas indexes in the treatment group were significantly better than those in the control group(P<0.05).After treatment,the HSP70 and H2S levels in two groups were significantly decreased(P<0.05),and which in the treatment group were significantly lower than those in the control group(P<0.05).During the treatment,the adverse reactions rate in the control group was 47.50%,which was significantly higher than 25.00%in treatment the group,with significant difference between two groups(P<0.05).Conclusion Poractant Alfa Injection combined with high frequency oscillatory ventilation can furthuer improve the clinical efficacy of HFOV in treatment of neonatal respiratory failure,improve the lung oxygenation function,reduce the serum levels of HSP70 and H2S,and reverse the anoxic state.