猪肺磷脂注射液联合无创通气治疗新生儿呼吸窘迫综合征疗效观察

Efficacy of poractant alfa injection combined with noninvasive ventilation in treating NRDS

目的探究猪肺磷脂注射液联合无创通气治疗新生儿呼吸窘迫综合征(NRDS)疗效。方法选取2021年2月至2023年4月收治的102例NRDS患儿为研究对象,其中57例接受无创通气治疗,设为A组;45例接受猪肺磷脂注射液联合无创通气治疗,设为B组。将2组患者按照1∶1最近临匹配法进行匹配,卡钳值为0.1,78例患者(无创通气治疗39例,联合治疗39例)配对成功,最终获得39对基线资料均衡可比的患者。比较治疗5 d后的临床疗效;比较2组患儿临床相关指标;记录2组患儿治疗前及治疗5 d后的血气指标[二氧化碳分压(PaCO_(2))、氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))]、炎症反应[血清C-反应蛋白(CRP)、降钙素原(PCT)]、心肌损伤[血清肌酸激酶(CK)、血清肌酸肌酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]水平。结果治疗5 d后,B组的临床疗效高于A组(P=0.033);B组临床相关指标均低于A组(P=0.040,0.029);2组患儿PaO_(2)、SaO_(2)水平均升高,且B组高于A组(P=0.024,0.032),2组患儿PaCO_(2)、CRP、PCT、CK、CK-MB、LDH水平均降低,且B组低于A组(P均<0.01)。结论对NRDS患儿使用猪肺磷脂注射液联合无创通气治疗,疗效确切,能显著改善患儿血气指标,降低炎症因子水平,减少心肌损伤程度。

ObjectiveTo exploretheefficacy of combination therapy of poractant alfainjection and noninvasive ventilation on neonatal respiratory distress syndrome(NRDS).Methods A total of 102 children with NRDS were selected as the study subjects from February 2021 to April 2023.Among these children,57 cases received noninvasive ventilation treatment and were set as group A.Another 45 cases were treated with poractant alfa injection combined with noninvasive ventilation and were assigned as group B.The two groups of patients were matched according to 1:1 nearest approach matching method(calliper=0.1),and then 78 patients(39 cases with noninvasive ventilation treatment and 39 cases with combined treatment)were matched successfully.Thus,39 pairs of patients with comparable baseline data were finally obtained.The clinical efficacy after 5 days of treatment and related clinical indicators were compared.The blood gas indicators[partial pressure of carbon dioxide(PacO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))],inflammatory response[serum C-reactive protein(CRP),procalcitonin(PCT)],myocardial injury[serum creatine kinase(CK),serum creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)]were recorded before treatment and after 5 days of treatment.Results After 5 days of the treatment,group B had obviously better clinical efficacy(P=0.033).The related clinical indicators in group B were lower compared to group A(P-0.040,0.029).The PaO_(2)and SaO_(2)in both groups were significantly increased,and the group B had higher PaO_(2)and SaO_(2)than those in group A(P<0.05).The PaCO_(2),CRP,PCT,CK,CK-MB and LDH were significantly decreased in the two groups,and the above indicators were lower in group B(all P<0.01).Conclusion Poractant alfa combined with noninvasive ventilation has an exact efficacy in the treatment of children with NRDS.It can significantly improve the blood gas indicators,reduce the inflammatory factors,and relieve the myocardial injury.