枸橼酸咖啡因联合磷酸肌酸钠治疗新生儿呼吸窘迫综合征的疗效观察

The Curative Effect Observation of the Citrate Caffeine Combined with the Creatine Phosphate Sodium for the Treatment of Neonatal Respiratory Distress Syndrome

目的:枸橼酸咖啡因联合磷酸肌酸钠治疗新生儿呼吸窘迫综合征的疗效,观察其对肺功能的影响。方法:选取我院新生儿科2016年6月至2019年6月收治的112例新生儿呼吸窘迫综合征的患儿作为研究对象,随机分为对照组和观察组(n=56)。对照组患儿采取枸橼酸咖啡因联合呼吸机辅助呼吸治疗,观察组患儿在对照组基础上再联合磷酸肌酸钠治疗,比较两组患儿临床疗效、血气分析指标、肺功能及心肌酶的变化,同时观察并发症支气管肺发育不良(BPD)的发生情况。结果:治疗后24 h及48 h,两组患儿PaO_(2)和PaO_(2)/FiO_(2)显著上升,PaCO_(2)明显下降(P<0.05);且观察组患儿PaO_(2)及PaO_(2)/FiO_(2)均高于对照组,差异有统计学意义(P<0.05)。治疗后24 h,两组患儿FEV1和FEV1/FVC较治疗前明显升高,观察组FEV1/FVC显著高于对照组(P<0.05)。治疗后48 h,患儿FEV1和FEV1/FVC进一步改善,观察组改善情况也优于对照组(P<0.05)。治疗后,患儿CK-MB和LDH水平较治疗前逐渐下降,且观察组CK-MB和LDH明显低于对照组(P<0.05)。观察组临床治疗总有效率为91.07%,显著高于对照组82.14%,且不良反应BPD发生率也低于对照组,差异有统计学意义(P<0.05)。结论:枸橼酸咖啡因联合磷酸肌酸钠治疗NRDS临床疗效显著,可有效改善患儿肺功能,减少心肌损伤,从而降低心肺不良反应并发症的发生率,有助于预后,值得临床推广与应用。

Objective:To explore the curative effect observation of the citrate caffeine combined with the creatine phosphate sodium for the treatment of neonatal respiratory distress syndrome,and analyze its influence on the on pulmonary function.Methods:112 cases of neonatal respiratory distress syndrome of children in our hospital were selected as the research object from June 2016 to June 2019,and were randomly divided into control group and observation group(n=56).Children in the control group were given the caffeine citrate with breathing machine auxiliary breath therapy,and patients of the observation group were treated with sodium phosphocreatine on the basis of the control group.The clinical curative effect,blood gas analysis index,pulmonary function and the changes of myocardial enzymes were compared in two groups.At the same time,the adverse complications occurrence of bronchial pulmonary dysplasia(BPD)was also observed.Results:After 24 h and 48 h treatment,PaO_(2)in two groups and considerably increased as well as PaO_(2)/FiO_(2),but PaCO_(2)was significantly decreased(P<0.05).PaO_(2)and PaO2/FiO2 in the observation group were higher than that of control group,the difference was statistically significant(P<0.05).After 24 h treatment,FEV1 and FEV1/FVC of two groups were obviously higher,and FEV1/FVC of the observation group was significantly higher than control group(P<0.05).After 48 h treatment,FEV1 and FEV1/FVC were further improved,which was significantly better than control group(P<0.05).After treatment,CK-MB and LDH levels in two groups were gradually declined,the LDH and CK-MB in the observation group were obviously lower than that of control group(P<0.05).The total effective rate of the observation group was 91.07%,significantly higher than control group 82.14%.The incidence of adverse reactions to BPD was lower than the control group with the statistically significant difference(P<0.05).Conclusions:The treatment of caffeine citrate combined with creatine sodium phosphocreatine for NRDS was effect,which can effectively improve the pulmonary function in children by reducing myocardial injury,and reduce the incidence of cardiopulmonary complications adverse reactions,help prognosis.It was worthy of clinical popularization and application.