| 聂振清,陈晓燕.机械通气联合不同肺表面活性物质在 新生儿呼吸窘迫综合征中的价值[J].安徽医药,2019,23(6):1222-1225. |
| 机械通气联合不同肺表面活性物质在 新生儿呼吸窘迫综合征中的价值 |
| Value of different pulmonary surfactant combined with mechanical ventilation in neonatal respiratory distress syndrome |
| 投稿时间：2017-06-06 |
| DOI： |
| 中文关键词: 新生儿呼吸窘迫综合征 机械通气 肺表面活性物质 临床价值 |
| 英文关键词: Neonatal respiratory distress syndrome Mechanical ventilation Pulmonary surfactant Clinical value |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨机械通气联合不同的肺表面活性物质在治疗新生儿呼吸窘迫综合征(NRDS)中的临床价值。方法 连续性纳入自2016年3月至2017年3月内蒙古医科大学附属医院新生儿监护室所收治的NRDS病人共72例,均给予持续气道内正压通气(CPAP)联合肺表面活性物质治疗。据病儿家庭经济条件及家长意见病儿分别接受猪肺磷脂注射液(40例)和注射用牛肺表面活性剂(32例)治疗,比较两组病儿临床治疗结果和并发症等情况。结果 肺表面活性物质治疗后两组病儿血气指标均较治疗前明显改善(均P＜0.05)。猪肺磷脂注射液组在用药后第4小时及第24小时血气氧分压[p(O2)]分别为(78.39±12.34)、(85.61±9.46) mmHg,显著性高于注射用牛肺表面活性剂组,差异有统计学意义(t4 h=2.079,P4 h=0.041;t24 h=2.257,P24 h=0.027)；猪肺磷脂注射液组第24小时血气二氧化碳分压[p(CO2)]为(38.16±11.72)mmHg,显著低于注射用牛肺表面活性剂组(t=2.193,P=0.031)。猪肺磷脂注射液组给药时间为(4.73±1.67) min(t=13.142,P<0.001),持续气道内正压通气(CPAP)时间为(96.34±22.17) h(t=3.227,P=0.002),均显著性低于注射用牛肺表面活性剂组,但两组重复给药比例及住院时间、并发症发生率、病死率均差异无统计学意义(均P＞0.05)。结论 猪肺磷脂注射液应用方便,可更加有效地改善病儿血气指标,缩短CPAP时间,且不增加病儿治疗风险。 |
| 英文摘要: |
| Objective To investigate the differences of clinical value of different pulmonary surfactant combined with mechanical ventilation in neonatal respiratory distress syndrome (NRDS).Methods Seventy-two cases of NRDS patients admitted to Department of Critical Care Medicine,Affiliated Hospital of Inner Mongolia Medical University from March 2016 to March 2017 were enrolled.Both groups were treated with the continuous airway pressure ventilation (CPAP) combined pulmonary surfactant.According to the decisions of parents and their family financial conditions,patients took Porcine pulmonary phospholipid injection (40 cases) or Bovine pulmonary surfactant for injection (32 cases).The clinical value and complications were compared between two groups.Results Indexes of blood gas in both groups were significantly ameliorated after pulmonary surfactant therapy (all P<0.05).p(O2) of 4 h [(78.39±12.34) mmHg,t=2.079,P=0.041] and 24 h [(85.61±9.46) mmHg, t=2.256,P=0.027] in Porcine pulmonary phospholipid injection group were significantly higher than those in Bovine pulmonary surfactant for injection group,and p(CO2) of 24 h [(38.16±11.72) mmHg, t=2.193,P=0.031] in Porcine pulmonary phospholipid injection group was significantly lower than that in Bovine pulmonary surfactant for injection group.The dosing time [(4.73±1.67) min,t=13.142,P<0.001] and CPAP time [(96.34±22.17) h,t=3.227,P=0.002] in Porcine pulmonary phospholipid injection group were significantly lower than those in Bovine pulmonary surfactant for injection group,but the dose repeated ratio,length of hospital stay,the complication rate and the mortality rate between the two groups had no staistical difference(all P>0.05).Conclusion Porcine pulmonary phospholipid injection was more convenient to use,and could better improve the blood gas indexes with shorter CPAP time and did not increase the risk. |
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