摘要
目的探讨微创肺表面活性物质给药(LISA)+布地奈德+同步鼻塞间歇正压通气(SNIPPV)治疗新生儿呼吸窘迫综合征(NRDS)的效果及对炎性因子、通气状态的影响。方法选取2019年4月至2021年4月收治的90例NRDS患儿为研究对象,根据随机数字表法将其分为对照组与观察组,各45例。对照组采用常规治疗+布地奈德+SNIPPV,观察组在对照组基础上加用LISA进行治疗。比较两组患者的治疗效果。结果观察组的治疗总有效率为95.56%,明显高于对照组的77.78%,差异具有统计学意义(P<0.05)。治疗后,观察组的降钙素原(PCT)、核因子-κB(NF-κB)、干扰素-γ(IFN-γ)、C反应蛋白(CRP)水平均低于对照组,白细胞介素-10(IL-10)水平高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))高于对照组,动脉血二氧化碳分压(PaCO_(2))低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的用力呼气量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC均高于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率为4.44%,低于对照组的20.00%,差异具有统计学意义(P<0.05)。结论LISA+布地奈德+SNIPPV治疗NRDS的整体效果显著,能够抑制炎性因子,改善患儿通气状态,促进肺功能恢复,并降低并发症发生率,值得推广。
Objective To investigate the effect of less invasive surfactant administration(LISA)+budesonide+synchronized nasal intermittent positive pressure ventilation(SNIPPV)in the treatment of neonatal respiratory distress syndrome(NRDS)and its influences on inflammatory factors and ventilation status.Methods A total of 90 children with NRDS admitted from April 2019 to April 2021 were selected as the study objects and divided into control group and observation group according to random number table method,with 45 cases in each group.The control group was treated with routine treatment+budesonide+SNIPPV,and the observation group was treated with LISA on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was 95.56%,which was significantly higher than 77.78%in control group,and the difference was statistically significant(P<0.05).After treatment,the levels of procalcitonin(PCT),nuclear factor-κB(NF-κB),interferon-γ(IFN-γ)and C-reactive protein(CRP)in the observation group were lower than those in the control group,the level of interleukin-10(IL-10)was higher than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the arterial oxygen partial pressure(PaO_(2))and arterial oxygen saturation(SaO_(2))in the observation group were higher than those in the control group,the arterial carbon dioxide partial pressure(PaCO_(2))was lower than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and FEV1/FVC in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 4.44%,which was lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion LISA+budesonide+SNIPPV in the treatment of NRDS has a significant overall effect,it can inhibit the inflammatory factors,improve the ventilation status,promote the recovery of lung function,and reduce the incidence of complications of children,which is worthy of promotion.
作者
罗立倩
何阿玲
杨冬
郭金珍
LUO Liqian;HE Aling;YANG Dong;GUO Jinzhen(Northwest Women's and Children's Hospital,Xi'an 710061,China)
出处
《临床医学研究与实践》
2022年第23期95-98,130,共5页
Clinical Research and Practice
关键词
微创肺表面活性物质给药
布地奈德
同步鼻塞间歇正压通气
新生儿呼吸窘迫综合征
炎性因子
通气状态
less invasive surfactant administration
budesonide
synchronized nasal intermittent positive pressure ventilation
neonatal respiratory distress syndrome
inflammatory factor
ventilation status
