高频振荡通气联合猪肺磷脂注射液治疗新生儿胎粪吸入综合征并肺动脉高压的效果

Effect of High-Frequency Oscillatory Ventilation Combined with Porcine Lung Phospholipid Injection in the Treatment of Neonatal Meconium Aspiration Syndrome with Pulmonary Hypertension

目的探讨高频振荡通气(HFOV)联合猪肺磷脂注射液治疗新生儿胎粪吸入综合征(MAS)并肺动脉高压(PPHN)的临床效果。方法选取平舆县人民医院2019年11月至2020年11月MAS并PPHN患儿94例,依据不同治疗方案分为观察组(n=47)与对照组(n=47)。两组均接受常规治疗,对照组接受HFOV治疗,观察组在对照组基础上接受猪肺磷脂注射液治疗。比较两组疗效、血气指标[动脉二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、肺动脉压(PAP)、经皮血氧饱和度(SaO_(2))、pH]、治疗情况、炎症反应[白细胞介素-8(IL-8)、白细胞介素-10(IL-10)]、呼吸功能[呼气峰流速值(PEFR)、最大自主通气(MVV)、呼吸道阻力(Raw)]、外周循环情况[心率(HR)、收缩压(SBP)、舒张压(DBP)、呼吸频率(R)]。结果观察组总有效率(97.87%)高于对照组(85.11%),通气、住院、肺部X线清晰、肺部啰音消失及发绀消失时间均短于对照组(P<0.05);治疗后观察组pH、PaO_(2)、SaO_(2)、PEFR、IL-10、MVV均高于对照组,PaCO_(2)、PAP、IL-8、Raw均低于对照组(P<0.05);治疗后观察组HR、R均低于对照组,SBP、DBP均高于对照组(P<0.05)。结论 HFOV联合猪肺磷脂注射液治疗新生儿MAS并PPHN效果显著,能有效促进患儿外周循环,改善患儿呼吸功能和通气状态,缩短治疗时间,抑制炎症反应。

Objective To investigate the clinical effect of high-frequency oscillatory ventilation(HFOV) combined with porcine lung phospholipid injection in the treatment of neonatal meconium aspiration syndrome(MAS) with pulmonary hypertension(PPHN).Methods A total of 94 children with MAS and PPHN in People’s Hospital of Pingyu County from November 2019 to November 2020 were selected and divided into observation group(n=47) and control group(n=47) according to different treatment plans.Both groups received conventional treatment,the control group received HFOV treatment,and the observation group received porcine lung phospholipid injection on the basis of the control group.The efficacy,blood gas indicators [arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),pulmonary artery pressure(PAP),transcutaneous oxygen saturation(SaO_(2)),pH],treatment status,inflammatory response [interleukin-8(IL-8),interleukin-10(IL-10)],respiratory function [peak expiratory flow rate(PEFR),maximum voluntary ventilation(MVV),airway resistance(Raw)],peripheral circulation conditions [heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),respiratory rate(R)] were compared.Results The total effective rate in the observation group was higher than in the control group(97.87% vs.85.11%).Ventilation,hospitalization,clear lung X-rays,disappearance of lung rales and disappearance of cyanosis were all shorter than those in the control group(P<0.05).After treatment,the pH,PaO_(2),SaO_(2),PEFR,IL-10,and MVV of the observation group were higher than those of the control group,and PaCO_(2),PAP,IL-8,and Raw were all lower than those of the control group(P<0.05).The HR and R of the observation group were lower than those of the control group,and the SBP and DBP were higher than those of the control group(P<0.05).Conclusion HFOV combined with porcine lung phospholipid injection has a significant effect in the treatment of neonatal MAS and PPHN.It can effectively promote the peripheral circulation of the patient,improve the patient’s respiratory function and ventilation,reduce the treatment time,and inhibit the inflammatory response.