不同剂量肺表面活性物质联合INSURE技术治疗新生儿呼吸窘迫综合征的效果观察

冯敏; 罗兵

doi:10.16766/j.cnki.issn.1674-4152.002143

不同剂量肺表面活性物质联合INSURE技术治疗新生儿呼吸窘迫综合征的效果观察

doi: 10.16766/j.cnki.issn.1674-4152.002143

冯敏^1, ,,
罗兵²

1.
安徽省第二人民医院儿科，安徽合肥 230000
2.
安徽省第二人民医院检验科，安徽合肥 230000

基金项目:

安徽省自然科学基金项目 KJ2019A1099

详细信息

通讯作者:
冯敏, E-mail: 418691145@qq.com

中图分类号: R722.12
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出版历程
- 收稿日期: 2020-10-30
- 网络出版日期: 2022-02-15

Clinical observation of different doses of pulmonary surfactant combined with INSURE technology in the treatment of neonatal respiratory distress syndrome

FENG Min^{1
, ,},
LUO Bing²

1.
Department of Pediatrics, Anhui No.2 Provincial People's Hospital, Hefei, Anhui 230000, China

摘要

摘要: 目的探讨不同剂量肺表面活性物质联合INSURE技术对新生儿呼吸窘迫综合征治疗效果的影响。方法选取2017年1月—2020年9月就诊于安徽省第二人民医院NICU 80例新生儿呼吸窘迫综合征为研究对象。按照随机数字法分为观察组和对照组，各40例，2组均给予INSURE技术注入肺表面活性物质(PS)治疗，其中对照组给予PS 70 mg/kg，观察组给予PS 100 mg/kg，比较2组患儿治疗前后的临床疗效、血气分析指标、氧合指数、用氧时间、住院时间以及并发症发生率。结果治疗后观察组(100.0%)临床总有效率高于对照组(85.0%，P < 0.05);观察组用氧时间明显短于对照组(P < 0.05);2组住院时间比较差异无统计学意义(P>0.05);2组治疗前血气分析结果及氧合指数比较差异无统计学意义(均P>0.05);治疗后血气分析结果及氧合指数均较治疗前明显改善，其中PaO₂上升，PaCO₂下降，pH改善，差异有统计学意义(均P < 0.05);观察组PaO₂[(77.55±5.79)mm Hg，1 mm Hg=0.133 kPa]明显高于对照组[(72.45±4.37)mm Hg]，PaCO₂[(39.45±2.45)mm Hg]低于对照组[(40.88±2.32)mm Hg]，观察组pH(7.36±0.02)改善优于对照组(7.35±0.02)，差异均有统计学意义(均P < 0.05);观察组并发症发生率(12.5%)低于对照组(35.0%，P < 0.05)。结论 100 mg/kg PS联合INSURE技术治疗新生儿呼吸窘迫综合征，可显著改善患者临床症状，改善氧合指数，减少用氧时间及临床并发症。
- 肺表面活性物质 /
- 新生儿 /
- 呼吸窘迫综合征 /
- 气管插管 /
- 经鼻持续气道正压通气 /
- 临床疗效
Abstract: Objective To investigate the clinical effect of different doses of pulmonary surfactant (PS) combined with INSURE technology in the treatment of neonatal respiratory distress syndrome. Methods A total of 80 neonatal respiratory distress syndrome cases in the NICU of Anhui No.2 Provincial People's Hospital from January 2017 to September 2020 were selected as the research objects. According to the random number method, the children were divided into two groups with 40 cases in each group. Both groups were treated with INSURE technology and injected with PS. The control group was given 70 mg/kg PS, and the experimental group was given 100 mg/kg PS. The clinical efficacy, blood gas analysis index, oxygenation index, oxygen duration, length of hospital stay and incidence of complications of the two groups were compared before and after treatment. Results The total effective rate of the experimental group (100.0%) was higher than that of the control group (85.0%), and the difference was statistically significant (P < 0.05). The duration of oxygen use in the experimental group was significantly shorter than that of the control group (P < 0.05). No difference was observed in the length of stay between the two groups (P>0.05). No significant difference was observed in blood gas analysis and oxygenation indices between both groups before treatment (P>0.05). The blood gas analysis and oxygenation index after treatment were significantly improved compared with those before treatment; that is, PaO₂ increased, PaCO₂ decreased, and pH improved (all P < 0.05). The PaO₂ [(77.55±5.79) mm Hg] of the experimental group was significantly higher than that of the control group [(72.45±4.37) mm Hg], whilst the PaCO₂ [(39.45±2.45) mm Hg] was lower than that of the control group [(40.88±2.32) mm Hg]. The pH of the experimental group (7.36±0.02) was significantly better than that of the control group (7.35±0.02), with statistically significant differences (P < 0.05). The complication rate of the experimental group (12.5%) was lower than that of the control group (35.0%), and the difference was statistically significant (P < 0.05). Conclusion The treatment of neonatal respiratory distress syndrome with 100 mg/kg PS combined with INSURE technology can significantly improve the clinical symptoms, improve oxygenation and reduce the duration of oxygen use and clinical complications.
- Pulmonary surfactant /
- Newborn /
- Respiratory distress syndrome /
- Tracheal intubation /
- Nasal continuous positive airway pressure ventilation /
- Clinical curative effect

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表 1 2组NRDS患儿临床总有效率比较[例(%)]

组别	例数	显效	有效	无效	总有效
观察组	40	22(55.0)	18(45.0)	0(0.0)	40(100.0)
对照组	40	8(20.0)	26(65.0)	6(15.0)	34(85.0)
注：2组总有效率比较，χ²=4.504, P=0.033。无同一例患儿出现2种及以上并发症。

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表 2 2组NRDS患儿用氧天数和住院天数比较(x ±s，d)

组别	例数	用氧时间	住院时间
观察组	40	7.63±5.84	21.08±9.26
对照组	40	11.53±9.02	21.33±11.89
t值		2.295	0.105
P值		0.025	0.917

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表 3 2组NRDS患儿治疗前后血气分析和氧合指数比较(x ±s)

组别	例数	pH		PaO₂(mm Hg)		PaCO₂(mm Hg)		OI(mm Hg)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	40	7.32±0.03	7.36±0.02^a	57.38±6.28	77.55±5.79^a	47.65±3.15	39.45±2.45^a	176.68±37.96	311.28±56.24^a
对照组	40	7.33±0.04	7.35±0.02^a	56.55±6.02	72.45±4.37^a	47.75±3.04	40.88±2.32^a	173.83±36.58	261.10±43.53^a
t值		0.256	2.597	0.600	4.447	0.145	2.720	0.342	4.462
P值		0.799	0.011	0.550	< 0.001	0.885	0.008	0.733	< 0.001
注：与治疗前比较，^aP < 0.05。1 mm Hg=0.133 kPa。

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表 4 2组NRDS患儿临床并发症比较[例(%)]

组别	例数	BPD	VAP	ROP	气胸	颅内出血	合计
观察组	40	1(2.5)	1(2.5)	2(5.0)	0(0.0)	1(2.5)	5(12.5)
对照组	40	3(7.5)	2(5.0)	4(10.0)	1(2.5)	4(10.0)	14(35.0)
注：2组并发症总发生率比较，χ²=5.591，P=0.018。

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