无创正压通气联合微创牛肺表面活性剂注射在RDS治疗中的应用及预后分析

Application and prognosis of continuous positive airway pressure combined with minimally invasive bovine pulmonary surfactant injection in the treatment of RDS

目的:探讨无创正压通气(CPAP)联合微创牛肺表面活性剂(PS)注射在呼吸窘迫综合征(RDS)治疗中的效果。方法:回顾性分析2018年8月~2021年8月在本院就诊的102例RDS早产儿,按照治疗方式分为通气组(26例)和注射组(76例),通气组给予CPAP治疗,注射组给予CPAP+PS治疗。比较治疗后两组患儿的临床疗效,记录机械通气时间、氧疗时间和住院时间,比较治疗前后炎症因子[白细胞(WBC)、降钙素原(PCT)和C反应蛋白(CRP)]、血气指标[动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))和动脉血二氧化碳分压(PaCO_(2))]以及治疗期间的并发症发生情况。结果:治疗后,注射组总有效率为93.42%,高于通气组76.92%;注射组机械通气时间、氧疗时间和住院时间均短于通气组;两组WBC、PCT和CRP水平均低于治疗前,且注射组WBC、PCT和CRP水平低于通气组;两组PaCO_(2)水平低于治疗前,SaO_(2)和PaO_(2)水平高于治疗前,且注射组PaCO_(2)水平低于通气组,SaO_(2)和PaO_(2)水平高于通气组;治疗期间,两组并发症发生情况无明显差异。结论:CPAP联合PS治疗RDS临床疗效好,恢复快,可以降低炎症反应,改善血气指标,安全性好。

Objective To explore the curative effect of continuous positive airway pressure (CPAP) combined with minimally invasive bovine pulmonary surfactant (PS) injection on respiratory distress syndrome (RDS).Methods A retrospective analysis was performed on the 102 premature infants with RDS treated in the hospital between August 2018 and August 2021.According to different treatment methods,they were divided into ventilation group (26 cases,CPAP) and injection group (76 cases,CPAP combined with PS).The clinical curative effect between the two groups was compared after treatment.The mechanical ventilation time,oxygen therapy time and hospitalization time were recorded.The inflammatory factors [white blood cells (WBC),procalcitonin (PCT),C-reactive protein (CRP)]and blood gas indexes [arterial partial pressure of blood (PaO_(2)),arterial blood oxygen saturation (SaO_(2)),arterial partial pressure of carbon dioxide (PaCO_(2))]before and after treatment,and complications during treatment were compared between the two groups.Results After treatment,total response rate of injection group was higher than that of ventilation group (93.42% vs 76.92%).The mechanical ventilation time,oxygen therapy time and hospitalization time in injection group were shorter than those in ventilation group.After treatment,levels of WBC,PCT and CRP in both groups were decreased,which were lower the injection group than ventilation group.After treatment,PaCO_(2) was decreased,while SaO_(2) and PaO_(2) were increased.After treatment,PaCO_(2) in injection group was lower than that in ventilation group,while SaO_(2) and PaO_(2) were higher than those in ventilation group.During treatment,there was no significant difference in the incidence of complications between the two groups.Conclusion The clinical curative effect of CPAP combined with PS is good on RDS,with fast recovery.Their combination can reduce inflammation response and improve blood gas indexes,with good safety.