小剂量牛肺表面活性物质结合高频震荡通气对新生儿呼吸衰竭临床症状及呼吸状态的改善效果观察

目的 探讨小剂量牛肺表面活性物质联合高频震荡通气(HFOV)对新生儿呼吸衰竭(NRF)临床症状及呼吸状态的改善效果。方法 选取88例NRF患儿为研究对象,根据其就诊时间随机将其分成研究组(A组,n=44)和对照组(B组,n=44)。B组予以常规治疗联合HFOV方案,A组则在上述治疗基础上联合小剂量牛肺表面活性物质经气管插管给药方案。比较两组患儿治疗前(T0)、治疗后3小时(T1)、治疗后6小时(T2)、治疗后24小时(T3)等不同时间点呼吸功能指标及动脉血气指标变化情况,记录其机械通气时间、氧疗时间及总住院时间差异,分析其治疗前后症状评分及治疗后转归、并发症发生情况。结果 ①T1-T3时,两组新生儿PaO₂水平均较T0时显著提升,且PaCO₂及氧合指数(OI)、吸入氧气体积分数(FiO₂)、MAP等呼吸功能指标均较T0时降低(P<0.05);其中A组新生儿各指标改善幅度大于B组新生儿(P<0.05);②A组新生儿机械通气时间、氧疗时间及总住院时间均短于B组新生儿(P<0.05);③治疗后24小时,两组患儿呼吸衰竭症状评分均较治疗前降低(P<0.05),其中A组患儿降幅大于B组患儿(P<0.05);④两组新生儿在病死率、治愈率及并发症发生率对比上均无统计学意义(P>0.05)。结论 对NRF患儿予以小剂量牛肺表面活性物质经气管插管给药联合HFOV疗法,安全有效,可有效提高患儿呼吸功能,对缓解其相关症状、改善呼吸状态等具有积极影响。

Observation on the improvement effect of low-dose bovine pulmonary surfactant combined with high-frequency oscillatory ventilation on clinical symptoms of neonatal respiratory failure and respiratory state

Objective To investigate the improvement effect of low-dose bovine pulmonary surfactant combined with high-frequency oscillatory ventilation (HFOV) on clinical symptoms of neonatal respiratory failure (NRF) and respiratory status.Methods 88 children with NRF were selected as the research objects.According to the time of treatment, the patients were divided into the research group (group A,n=44) and the control group (group B,n=44) of two groups.Group B was treated with conventional therapy combined with HFOV scheme while group A was treated with low-dose bovine pulmonary surfactant through trachea cannula as the drug regimen,based on the above treatment.The changes of respiratory function indexes and arterial blood gas indexes in the two groups before the treatment (T0),3h (T1),6h (T2) and 24h (T3) after the treatment were compared.The differences in mechanical ventilation time,oxygen therapy time and total length of hospital stays were recorded.The symptom scores,outcome of the treatment and the occurrence of complications were analyzed.Results ①In T1-T3,the levels of PaO₂ in the two groups were significantly higher than those in T0,and the respiratory function indexes like PaCO₂,OI,MAP and FiO₂ were significantly lower than those in T0 (P<0.05).The improvement of the indexes in group A was significantly higher than that in group B (P<0.05); ②The time of mechanical ventilation,oxygen therapy and total length of hospital stays of group A was significantly shorter than that of group B (P<0.05); ③24h of treatment later,the scores of respiratory failure symptoms of the two groups were significantly lower than those before the treatment (P<0.05) and the decline in group group A was greater than that in group B (P<0.05); ④There was statistical significance in the comparisons of mortality,cure rate and incidence rate of complications between the two groups (P>0.05).Conclusion The curative effect of application of low-dose bovine pulmonary surfactant through trachea cannula as the drug regimen combined with HFOV therapy in children with NRF is exact.The safety of drug use is prominent.It can effectively improve the respiratory function of the diseased children and has positive effect on alleviating the related symptoms and improving the respiratory status.It is worthy of clinical promotion.