| 不同机械通气方式联合猪肺磷脂注射液治疗新生儿呼吸衰竭疗效比较 |
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| 引用本文： | 赵杰,朱萍,苌俊明,别静洋,李德亮,王海云,杨柳. 不同机械通气方式联合猪肺磷脂注射液治疗新生儿呼吸衰竭疗效比较[J]. 新乡医学院学报, 2023, 0(1): 067-72. DOI: 10.7683/xxyxyxb.2023.01.012 |
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| 作者姓名： | 赵杰 朱萍 苌俊明 别静洋 李德亮 王海云 杨柳 |
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| 作者单位： | （南阳市中心医院新生儿重症监护病区，河南 南阳 473005） |
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| 摘 要： | 目的 比较常频机械通气(CMV)、猪肺磷脂注射液联合CMV、猪肺磷脂注射液联合高频振荡通气(HFOV)治疗新生儿呼吸衰竭的疗效。方法 选择2019年1月至2020年12月南阳市中心医院收治的133例呼吸衰竭新生儿为研究对象，根据治疗方式将患儿分为对照组(n=41)、观察组A(n=45)和观察组B(n=47)。对照组患儿给予单纯CMV治疗，观察组A患儿给予猪肺磷脂注射液联合HFOV治疗，观察组B患儿给予猪肺磷脂注射液联合CMV治疗。比较3组患儿机械通气时间、用氧时间、治疗前后的呼吸力学指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数(OI)、呼吸指数(RI)]和血清内皮素-1(ET-1)、肌酸激酶同工酶(CK-MB)、Ⅱ型肺泡表面抗原-6(KL-6)、Clara细胞蛋白16(CC16)水平及不良反应发生情况。结果 3组患儿的机械通气时间和用氧时间比较差异有统计学意义(F=12.658、26.196,P<0.05);观察组A和观察组B患儿的机械通气时间和用氧时间显著短于对照组(P<0.05),观察组A患儿的机...
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| 关 键 词： | 猪肺磷脂注射液 常频机械通气 高频振荡通气 新生儿呼吸衰竭 |
Comparison of the efficacy of different mechanical ventilation combined with porcine lung phospholipid injection in the treatment of neonatal respiratory failure |
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| ZHAO Jie,ZHU Ping,CHANG Junming,BIE Jingyang,LI Deliang,WANG Haiyun,YANG Liu. Comparison of the efficacy of different mechanical ventilation combined with porcine lung phospholipid injection in the treatment of neonatal respiratory failure[J]. Journal of Xinxiang Medical College, 2023, 0(1): 067-72. DOI: 10.7683/xxyxyxb.2023.01.012 |
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| Authors: | ZHAO Jie ZHU Ping CHANG Junming BIE Jingyang LI Deliang WANG Haiyun YANG Liu |
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| Affiliation: | (Neonatal Intensive Care Unit,Nanyang Central Hospital,Nanyang 473005,Henan Province,China) |
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| Abstract: | Objective To compare the efficacy of conventional mechanical ventilation (CMV)，porcine lung phospholipid injection combined with CMV，porcine lung phospholipid injection combined with high-frequency oscillatory ventilation (HFOV) in the treatment of neonatal respiratory failure.Methods A total of 133 newborns with respiratory failure admitted to Nanyang Central Hospital from January 2019 to December 2020 were selected as the research objects,and the children were divided into the control group (n=41)，observation group A (n=45) and observation group B (n=47) according to the different treatment methods.The children in the control group were given CMV treatment，the children in the observation group A were given porcine lung phospholipid injection combined with HFOV treatment，and the children in the observation group B were given porcine lung phospholipid injection combined with CMV treatment.The time of mechanical ventilation,time of oxygen use,the respiratory mechanics indexes［including the arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2)，oxygenation index (OI) and respiratory index (RI)］ and serum endothelin-1 (ET-1)，creatine kinase isoenzyme (CK-MB)，krebs yon denlundgen-6 (KL-6)，Clara cell secretory protein 16 (CC16) as well as the occurrence of adverse reactions of the children among the three groups were compared.Results There were significant difference in the time of mechanical ventilation and time of oxygen use of the children among the three groups (F=12.658,26.196;P<0.05);the time of mechanical ventilation and time of oxygen use of children in the observation group A and observation group B were significantly shorter than those in the control group (P<0.05)，and the time of mechanical ventilation and time of oxygen use of children in the observation group A were significantly shorter than those in observation group B (P<0.05).At 12，24，48 and 72 hours of treatment,the PaO2 was significantly higher than that before treatment，and PaCO2，RI,OI were significantly lower than those before treatment in the three groups (P<0.05).At 12，24 and 48 hours of treatment，the PaO2 of children in the observation group A and observation group B was significantly higher than that in the control group，and the PaO2 of children in the observation group A was significantly higher than that in the observation group B (P<0.05);at 12，24 and 48 hours of treatment，the PaCO2 of children in the observation group A and observation group B was significantly lower than that in the control group，and the PaCO2 of children in the observation group A was significantly lower than that in the observation group B (P<0.05);at 12,24,48,72 hours of treatment,the RI and OI of children in the observation group A and observation group B were significantly lower than those in the control group，and the RI and OI of children in the observation group A were significantly lower than those in the observation group B (P<0.05).Before treatment，there was no significant difference in serum ET-1，CK-MB，KL-6 and CC16 levels of children among the three groups (P>0.05);the levels of serum ET-1，CK-MB，KL-6 and CC16 of children at 72 hours of treatment were significantly lower than those before treatment in the three groups (P<0.05);at 72 hours of treatment，the levels of serum ET-1，CK-MB，KL-6 and CC16 of children in the observation group A and observation group B were significantly lower than those in the control group，and the levels of serum ET-1，CK-MB，KL-6 and CC16 of children in the observation group A were significantly lower than those in the observation group B (P<0.05).The total adverse reaction rates of children in the control group，observation group A and observation group B were 43.90% (18/41)，20.00% (9/45) and 27.66% (13/47)，respectively.There were significant difference in the total adverse reaction rates among the three groups(χ2=4.859,P<0.05);the total adverse reaction rate of children in observation group A was significantly lower than that in the control group (P<0.05);there was no significant difference in the total adverse reaction rate between the observation group A and observation group B (χ2=1.827,P>0.05);and there was no significant difference in the total adverse reaction rate between observation group B and control group (χ2=1.034,P>0.05).Conclusion Compared with CMV and porcine lung phospholipid injection combined with CMV therapy，porcine lung phospholipid injection combined with HFOV in the treatment of neonatal respiratory failure can more effectively shorten the time of mechanical ventilation and oxygen use,reduce the serum ET-1，CK-MB，KL-6，CC16 levels，improve oxygenation function，reduce inflammation and damage to myocardial cells，and reduce the adverse reactions. |
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| Keywords: | porcine lung phospholipid injection conventional mechanical ventilation high-frequency oscillatory ventilation neonatal respiratory failure |
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