摘要
目的:观察肺泡表面活性物质联合容量目标通气治疗新生儿呼吸窘迫综合征(NRDS)对患儿Th1/Th2细胞因子水平及血气状况的影响。方法:选取2019年1月-2020年6月笔者所在医院收治的60例NRDS患儿作为研究对象。按照随机数表法分为对照组和观察组,各30例。两组均给予肺泡表面活性物质治疗,对照组采用机械通气治疗(SIMV或SIMV+PSV模式),观察组给予容量目标通气治疗。1周后,分析两组治疗效果、Th1细胞因子干扰素-γ(IFN-γ)、Th2因子白介素-4(IL-4)、二氧化碳分压(PaCO2)、血氧饱和度(SpO2)、动脉血氧分压(PaO2)、氧合指数(OI)及并发症发生情况。结果:观察组治疗总有效率为96.7%,高于对照组的80.0%,差异有统计学意义(P<0.05)。治疗前,两组IFN-γ、IL-4、IFN-γ/IL-4、PaO2、PaCO2、OI、SpO2比较差异无统计学意义(P>0.05);治疗后,观察组IFN-γ、IFN-γ/IL-4、PaCO2均低于对照组,而IL-4、PaO2、OI、SpO2均高于对照组,差异均有统计学意义(P<0.05)。观察组并发症总发生率为6.7%,低于对照组的26.7%,差异有统计学意义(P<0.05)。结论:肺泡表面活性物质联合容量目标通气对新生儿NRDS效果显著,可明显改善患儿通气功能,促进Th1/Th2细胞因子的动态平衡,减少并发症,在临床中值得推广应用。
Objective:To observe the effects of alveolar surfactant combined with volume target ventilation on the levels of Th1/Th2 cytokines and blood gas in neonatal respiratory distress syndrome(NRDS).Method:A total of 60 children with NRDS admitted to the author’s hospital from January 2019 to June 2020 were selected as the research subjects.They were randomly divided into the control group and the observation group,30 cases in each group.Both groups were treated with pulmonary surfactant,the control group was treated with mechanical ventilation(SIMV or SIMV+PSV mode),and the observation group was treated with volume target ventilation.One week later,the treatment effect,Th1 cytokine interferon-γ(IFN-γ),Th2 factor interleukin-4(IL-4),partial pressure of carbon dioxide(PaCO2),blood oxygen saturation(SpO2),arterial partial pressure of oxygen(PaO2),oxygen index(OI)and complications were analyzed.Result:The total effective rate in the observation group was 90.0%,higher than 66.7%in the control group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in IFN-γ,IL-4,IFN-γ/IL-4,PaO2,PaCO2,OI,SpO2 between the two groups(P>0.05),after treatment,IFN-γ,IFN-γ/IL-4 and PaCO2 in the observation group were lower than those in the control group,while IL-4,PaO2,OI and SpO2 were higher than those in the control group,the differences were statistically significant(P<0.05).The total complication rate in the observation group was 6.7%,lower than 26.7%in the control group,the difference was statistically significant(P<0.05).Conclusion:Alveolar surfactant combined with volume target ventilation has a significant effect on neonatal NRDS,which can significantly improve the ventilation function of children,promote the dynamic balance of Th1/Th2 cytokines,and reduce complications.Therefore,it is worthy of promotion and application in clinical practice.
作者
李碧燕
班奕
汤玉妍
万忠和
LI Biyan;BAN Yi;TANG Yuyan;WAN Zhonghe(The Nanhai District People’s Hospital of Foshan City,Foshan 528200,China)
出处
《中外医学研究》
2021年第6期138-141,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
肺泡表面活性物质
容量目标通气
新生呼吸窘迫综合征
血气分析
新生儿
Alveolar surfactant
Volume target ventilation
Neonatal respiratory distress syndrome
Blood gas analysis
Newborn
