摘要
目的:探究低侵入微创给予肺表面活性物质(LISA)联合枸橼酸咖啡因在新生儿呼吸窘迫综合征(NRDS)中的疗效及对血气指标、通气时间的影响。方法:选取我院2020年9月到2022年9月收治的143例NRDS患儿,按双色球随机分组法分为联用组(n=72,LISA联合枸橼酸咖啡因治疗)和常规组(n=71,LISA治疗)。比较两组临床疗效、呼吸力学指标[内源性呼气末正压、气道阻力、静态顺应性]、血气指标[二氧化碳分压(PaCO_(2))、氧分压(PaO_(2))、血酸碱度(pH)值]、机械通气时间、氧疗时间、呼吸暂停、治疗并发症等情况。结果:两组治疗总有效率比较差异无统计学意义(P>0.05),但联用组治疗显效率高于常规组(P<0.05);两组治疗后内源性呼气末正压及气道阻力均低于治疗前,静态顺应性高于治疗前,且联用组治疗前后内源性呼气末正压、气道阻力及静态顺应性变化幅度均大于常规组(P<0.05);两组治疗后PaCO_(2)低于治疗前,PaO_(2)及pH值高于治疗前,且联用组治疗前后PaCO_(2)及PaO_(2)变化幅度大于常规组(P<0.05);联用组机械通气时间、氧疗时间及呼吸暂停次数均少于常规组(P<0.05);联用组患儿出现支气管肺发育不良及呼吸机相关性肺炎发生率低于常规组(P<0.05)。结论:LISA联合枸橼酸咖啡因治疗NRDS的效果显著,可明显改善患儿血气分析指标,缩短通气时间,安全性较好,值得临床推广应用。
Objective:To explore the effect of less invasive surfactant administration(LISA)combined with caffeine citrate in the treatment of neonatal respiratory distress syndrome(NRDS)and its influence on blood gas indicators and ventilation time.Methods:A total of 143 children with NRDS admitted to the hospital from September 2020 to September 2022 were selected and divided into combination group(n=72,LISA combined with caffeine citrate treatment)and conventional group(n=71,LISA treatment)according to the two-color sphere random grouping method.The clinical efficacy,respiratory mechanics indicators[endogenous positive end-expiratory pressure,airway resistance,static compliance],blood gas indicators[partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),blood power of hydrogen(pH)value],mechanical ventilation time,oxygen therapy time,apnea and treatment complications were compared between the two groups.Results:There was no statistical difference in the overall effective rate between the two groups(P>0.05),but the markedly effective rate in combination group was higher than that in conventional group(P<0.05).After treatment,the endogenous positive end expiratory pressure and airway resistance in both groups were lower than before treatment,while static compliance was higher than before treatment(P<0.05).Moreover,the amplitude of changes in endogenous positive end expiratory pressure,airway resistance,and static compliance in the combination group before and after treatment was greater than that in the conventional group(P<0.05).After treatment,the PaCO_(2) levels in both groups were lower than before treatment,while the PaO_(2) and pH values were higher than before treatment(P<0.05).Moreover,the changes in PaCO_(2) and PaO_(2) levels in the combination group before and after treatment were greater than those in the conventional group(P<0.05).The mechanical ventilation time,oxygen therapy time,and apnea frequency in combination group were shorter or less than those in conventional group(P<0.05).Th
作者
蔡枚龄
羊才进
羊威
杨路
陈焕秋
符红波
CAI Meiling;YANG Caijin;YANG Wei(Hainan Western Central Hospital,Hainan Danzhou 571700,China)
出处
《河北医学》
CAS
2023年第8期1335-1340,共6页
Hebei Medicine
基金
海南省卫生计生行业科研项目,(编号:16A200012)。
