肺表面活性物质辅助机械通气对早产儿呼吸窘迫综合征的治疗效果分析

Analysis of the therapeutic effect of lung surface active substance-assisted mechanical ventilation in preterm infants with respiratory distress syndrome

目的:探究肺表面活性物质(Pulmonary surfactant,PS)辅助机械通气治疗早产儿呼吸窘迫综合征(Neonatal respiratory distress Syndrome,NRDS)的临床疗效、肺功能和安全性的影响.方法:选取2020年5月至2023年9月在本院收治的NRDS患儿62例为研究对象,根据治疗方案不同分为对照组30例(常规治疗基础上实施机械通气)和观察组32例(在对照组基础上联合PS治疗).比较两组NRDS患儿临床疗效、治疗前后肺功能[肺动态顺应性(Dynamic lung Compliance,CD)、氧合指数(Oxygenation index,PaO_(2)/FiO_(2))、吸气阻力(Inspiratory resistance,RAWO)]指标变化、住院时间、呼吸机使用时间和并发症发生率.结果:治疗后,观察组治疗总有效率明显高于对照组(P<0.05).治疗后,两组CD、PaO_(2)/FiO_(2)均显著上升,RAWO均显著下降,且观察组CD、PaO_(2)/FiO_(2)明显高于对照组,RAWO明显低于对照组(P<0.05).治疗后,观察组平均住院时间、平均呼吸机使用时间均明显短于对照组,且并发症总发生率明显低于对照组(P<0.05).结论:PS辅助机械通气治疗NRDS可以促进患儿肺功能恢复,提高临床疗效,且安全性较高.

Objective:To investigate the clinical efficacy,pulmonary function and safety of pulmonary surfactant(PS)assisted mechanical ventilation in the treatment of premature respiratory distress syndrome(NRDS).Methods:Sixty-two children with NRDS admitted to our hospital from May 2020 to September 2023 were selected for the study,and were divided into 30 cases in the control group(mechanical ventilation on the basis of conventional treatment)and 32 cases in the observation group(combined with PS treatment on the basis of the control group)according to the different treatment plans.We compared the clinical efficacy,changes in lung function[Dynamic lung compliance(CD),Oxygenation index(PaO_(2)/FiO_(2)),Inspiratory resistance(RAWO)]indexes,length of hospitalisation,duration of ventilator use,and complication rate of children with NRDS in the two groups before and after treatment.Results:After treatment,the total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).After treatment,CD and PaO_(2)/FiO_(2)increased significantly and RAWO decreased significantly in both groups,and CD and PaO_(2)/FiO_(2)were significantly higher in the observation group than in the control group,and RAWO was significantly lower than in the control group(P<0.05).After treatment,the average hospitalisation time and average ventilator use time of the observation group were significantly shorter than those of the control group,and the total incidence of complications was significantly lower than that of the control group(P<0.05).Conclusion:PS-assisted mechanical ventilation for the treatment of NRDS can promote the recovery of children's lung function,improve clinical efficacy,and has a high degree of safety.