经鼻间歇正压通气与大剂量牛肺表面活性剂治疗重症新生儿呼吸窘迫综合征的效果研究

目的 探讨经鼻间歇正压通气与大剂量牛肺表面活性剂治疗重症新生儿呼吸窘迫综合征的应用效果。方法 选取2019年3月—2020年6月在本院就诊的新生儿呼吸窘迫综合征患儿102例,按随机数字表法分为两组,各51例。2组患儿均接受经鼻间歇正压通气辅助呼吸及注射用牛肺表面活性剂治疗,对照组采用标准剂量治疗,观察组采用大剂量治疗。对比2组临床疗效、临床相关指标、血气分析指标,并记录两组不良反应发生情况。结果 观察组治疗总有效率为96.08%,高于对照组的84.31%,(χ2=3.991,P＜0.05)。观察组用药次数、住院时间、氧疗时间及机械通气时间为(1.21±0.26)次、(14.42±2.14)d、(79.25±7.36)h、(65.24±5.01)h,短于对照组的(1.58±0.45)次、(18.74±3.87)d、(88.24±7.85)h、(74.17±6.21)h(t=5.084、6.976、5.966、7.993,P均＜0.05);观察组治疗3 d后血氧分压(partial pressure of oxygen,PaO2)、氧合指数分别为(88.45±6.21)mm Hg、(350.21±12.25)mm Hg,高于对照组的(81.36±5.14)mm Hg、(336.14±11.41)mm Hg,二氧化碳分压(Partial Pressure of Carbon Dioxide,PaCO2)为(43.14±3.65)mm Hg,低于对照组的(50.21±4.35)mm Hg,(t=6.281、6.002、8.892,F=39.446、79.042、36.026,P值均＜0.05)。2组均无严重不良反应发生。结论 经鼻间歇正压通气与大剂量牛肺表面活性剂治疗重症新生儿呼吸窘迫综合征患儿利于改善患儿氧合指数,进而减少机械排气时间及住院时间,值得应用。

Effect of nasal intermittent positive pressure ventilation and high-dose bovine lung surfactant in treatment of severe neonatal respiratory distress syndrome

Objective To investigate the application effect of nasal intermittent positive pressure ventilation and high-dose bovine lung surfactant in the treatment of children with severe neonatal respiratory distress syndrome (NRDS). Methods A total of 102 children with NRDS who visited our hospital from March 2019 to June 2020 were enrolled and divided into two groups according to the random number table method, with 51 children in each group. The children in both groups received nasal intermittent positive pressure ventilation to assist breathing and bovine lung surfactant for injection, the control group was treated with a standard dose, and the observation group was treated with a high dose. The clinical efficacy, clinical-related indexes, and blood gas analysis indexes of the two groups were compared, and the occurrence of adverse reactions in the two groups was recorded. Results The overall response rate of treatment in the observation group was 96.08%, higher than that of the control group: 84.31% (χ2=3.991, P<0.05). The number of medications, length of hospital stays, duration of oxygen therapy, and duration of mechanical ventilation in the observation group were (1.21±0.26) times, (14.42±2.14) d, (79.25±7.36) h, and (65.24±5.01) h, shorter than those of the control group: (1.58±0.45) times, (18.74±3.87) d, (88.24±7.85) h, and (74.17±6.21) h (t=7.993, 5.966, 5.084, 6.976, all P<0.05). The partial pressure of oxygen (PaO2) and oxygenation index in the observation group were (88.45±6.21) mmHg and (350.21±12.25) mmHg, respectively, which were higher than those in the control group: (81.36±5.14) mmHg and (336.14±11.41) mmHg, the partial pressure of carbon dioxide (PaCO2) in the observation group was (43.14±3.65) mmHg, lower than that in the control group: (50.21±4.35) mmHg (t=6.281, 6.002, 8.892, F=39.446, 79.042, 36.026, all P<0.05). There were no serious adverse effectsin either group. Conclusion Nasal intermittent positive pressure ventilation and high-dose bovine lung surfactant in the treatment of children with severe NRDS are conducive to improving the oxygenation index of children, thereby reducing mechanical exhaust time and hospital stay, which is worth applying.