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投稿时间:2023-07-25 网络发布日期:2023-12-20
投稿时间:2023-07-25 网络发布日期:2023-12-20
中文摘要: 目的 探讨机械通气不同时间段使用肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征(NRDS)对患儿血气指标和肺功能指标的影响。
方法选取2021年2月至2023年2月南京江北医院新生儿重症监护病房收治的NRDS患儿80例,按照随机数字表法分为观察组(A、B、C)3组和对照组各20例。四组患儿均实施常规机械通气、综合治疗,并连续治疗72 h。观察组A、B、C分别在机械通气后0.5 h内、2~4 h、4~6 h使用相同剂量PS(70 mg/kg)缓慢注射进气管插管内。比较四组患儿机械通气前、PS治疗后6 h血气指标、 肺功能指标,PS治疗后24 h临床疗效和并发症发生情况。
结果 观察组A、B、C各组使用PS后6 h比较,血气指标(PaO2、PaCO2、pH值)好转幅度依次下降,明显优于对照组,差异有统计学意义(P<0.05)。观察组A、B、C各组使用PS后比较肺功能指标,患儿自主呼吸次数、肺顺应性、血氧饱和度恢复正常范围时间依次延长,但明显优于对照组,差异有统计学意义(P<0.05)。观察组治疗总效率明显高于对照组(98.33% vs 80.00%, χ2=5.760,P=0.016)。治疗期间观察组并发症发生率明显低于对照组(3.33% vs 25.00%, χ2=6.314,P=0.012)。
结论 机械通气联合PS治疗NRDS能改善患儿预后,使用PS的时间越早,效果越好。
Abstract:Objective To investigate the effect of using pulmonary surfactant (PS) during different time periods of mechanical ventilation in the treatment of neonatal respiratory distress syndrome (NRDS) on blood gas and lung function indicators in children.
Methods A total of 80 children with NRDS who received treatment at Neonatal Intensive Care Unit, Nanjing Jiangbei Hospital from February 2021 to February 2023 were selected and divided into observation group A, observation group B, observation group C and control group randomly (n=20, each). All the children received routine mechanical ventilation and comprehensive treatment for 72 hours. In the observation group A, B and C, the same dose of PS (70 mg/kg) was slowly injected into the intake pipe intubation within 0.5 h, 2-4 h and 4-6 h after mechanical ventilation, respectively. The blood gas indexes, lung function indexes, clinical efficacy and complications of the four groups before mechanical ventilation and 6 hours after PS treatment were compared.
Results The improvement of blood gas indexes (PaO2, PaCO2, pH value) in the observation group A, B and C were significantly better than those in the control group at 6 h after PS (P<0.05). The pulmonary function indexes, spontaneous breathing times, lung compliance and blood oxygen saturation recovery time of children in observation group A, B and C after using PS were prolonged in turn, but they were significantly better than those in control group (P<0.05). The total efficiency of the observation group was significantly higher than that of the control group (98.33% vs 80.00%, χ2=5.760, P=0.016). The incidence of complications in the observation group during treatment was significantly lower than that in the control group (3.33% vs 25.00%, χ2=6.314, P=0.012).
Conclusion The combination of mechanical ventilation and PS treatment can improve the prognosis of children with NRDS. The earlier the use of PS, the better the effect.
keywords: Respiratory distress syndrome Newborn Pulmonary surfactant Blood gas analysis Lung function Mechanical ventilation Complication Medication time
文章编号: 中图分类号:R722.1 文献标志码:B
基金项目:
Author Name | Affiliation |
ZHU Ling, LI Jun | Department of Pediatrics, Nanjing Jiangbei Hospital Affiliated to Nantong University Xinglin College, Nanjing, Jiangsu 211500, China |
引用文本:
朱灵,李俊.不同时间使用肺表面活性物质治疗新生儿呼吸窘迫综合征的临床疗效[J].中国临床研究,2023,36(12):1861-1865.
朱灵,李俊.不同时间使用肺表面活性物质治疗新生儿呼吸窘迫综合征的临床疗效[J].中国临床研究,2023,36(12):1861-1865.