肺表面活性物质联合NIPPV对新生儿呼吸窘迫综合征患儿肺功能和血气指标的影响

目的探讨肺表面活性物质联合无创正压通气(NIPPV)对新生儿呼吸窘迫综合征肺功能及血气指标的影响。方法选择2015年1月-2018年2月温州医科大学附属平阳医院接诊的63例呼吸窘迫综合征新生儿随机分为观察组33例和对照组30例,对照组给予NIPPV治疗,观察组在对照组基础上联合肺表面活性物质治疗,均连续治疗1周,比较两组临床治疗效果、血气指标、肺功能的变化和并发症。结果治疗后,观察组临床治疗总有效率96.97%明显高于对照组的80.00%,差异有统计学意义(P<0.05)。观察组第一秒最大呼气容积(FEV1)、FEV1与用力肺活量比值(FEV1/FVC)、最大呼气流量(PEF)均高于对照组,动脉氧分压(PaO2)、血氧饱和度(Sp O2)高于对照组,动脉二氧化碳分压(PaCO2)低于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率9.09%明显低于对照组的30.00%,差异有统计学意义(P<0.05)。结论肺表面活性物质联合NIPPV治疗新生儿呼吸窘迫综合征效果显著,能有效改善血气指标,促进肺功能恢复,利于提升治疗效果,且并发症少,值得在临床应用中推广。

Effect of pulmonary surfactant combined with NIPPV on pulmonary function and blood gas indexes in neonatal respiratory distress syndrome

Objective To explore the effect of pulmonary surfactant combined with non-invasive positive pressure ventilation( NIPPV)on pulmonary function and blood gas indexes in neonatal respiratory distress syndrome. Methods Sixty-three neonates with respiratory distress syndrome treated in Pingyang Hospital Affiliated to Wenzhou Medical University from January 2015 to February 2018 were selected and randomly divided into observation group( 33 neonates) and control group( 30 neonates). The neonates in control group were treated by NIPPV;the neonates in observation group were treated by NIPPV combined with pulmonary surfactant. The neonates in the two groups were treated for one week. The curative effects,blood gas indexes,changes of pulmonary function,and complications were compared between the two groups. Results After treatment,the total effective rate in observation group was 96. 97%,which was statistically significantly higher than that in control group( 80. 00%)( P<0. 05). Forced expiratory volume in one second( FEV1),FEV1/forced vital capacity( FVC),peak expiratory flow( PEF),arterial partial pressure of oxygen( PaO2),and blood oxygen saturation( Sp O2) in observation group were statistically significantly higher than those in control group,arterial partial pressure of carbon dioxide( PaCO2) in observation group was statistically significantly lower than that in control group( P<0. 05). The incidence rate of complications in observation group was 9. 09%,which was statistically significantly lower than that in control group( 30. 00%)( P<0. 05). Conclusion The effect of pulmonary surfactant combined with NIPPV in treatment of neonatal respiratory distress syndrome is remarkable. The therapy can effectively improve blood gas indexes,promote the recovery of pulmonary function,improve the treatment effect with few complications,which is worthy of clinical application and promotion.