肺表面活性物质联合双水平气道正压通气对早产儿呼吸窘迫综合征肺功能及安全性影响

目的 分析肺表面活性物质(PS)联合双水平气道正压通气(BiPAP)对早产儿呼吸窘迫综合征(RDS)肺功能、氧合功能、血清指标及安全性影响.方法 选取2017年1月至2019年1月三亚中心医院治疗的RDS早产儿120例,采用随机数字表法分为对照组和观察组,各60例.对照组采用PS联合持续气道正压通气(CPAP)治疗,观...

Effects of pulmonary surfactant and bilevel positive airway pressure on lung function and safety of RDS in preterm infants

Objective To analyze the effects of pulmonary surfactant and bilevel positive airway pressure (BiPAP) on lung function,oxygenation function, serum index and safety of preterm infants with respiratory distress syndrome (RDS).Methods One hundred and twenty cases of premature infants with RDS who were treated in Sanya Central Hospital from January 2017 to January 2019 were ran.domly assigned into control group and observation group, each group with 60 cases. Control group was treated with pulmonary surfac.tant (PS) combined with BiPAP combined with continuous positive airway pressure (CPAP), while the observation group was treatedwith PS combined with BiPAP. The pulmonary function, arterial blood gas indexes, oxygen exchange indexes, serum factors and compli.cations were observed in the two groups.Results The minute ventilation [(0.53±0.04) L·min-1·kg-1 vs. (0.44±0.05) L·min-1·kg-1] and tidal volume [(6.49±1.30) mL/kg vs. (5.48±1.15) mL/kg] of the observation group were higher than those of the control group, and the re.spiratory rate was lower than that of the control group [(42.51±3.94) times/min vs. (49.32±4.02) times/min] (P<0.05). There was no sig.nificant difference in TEF25%, TEF50%, TEF75%, peak time ratio, peak expiratory flow rate (PEF) and peak volume ratio (P>0.05); the pH value, arterial partial pressure of oxygen (PaO₂), PaO₂/PAO₂, PaO₂/FiO₂ of the observation group at 6 h and 12 h after treatmentwere higher than those before treatment and the control group, and the arterial partial pressure of carbon dioxide (PaCO₂) was lower than before treatment and the control group (P<0.05). Serum high mobility group protein 1 (HMGB-1), macrophage migration inhibitory factor-1 (MIF-1) and type II alveolar cell surface antigen (KL-6) levels of the observation group after 3 days of treatment were lower than those of before treatment and the control group (P<0.05). The hospitalization and oxygen therapy time of children of the observa. tion group was lower than that of the control group (P<0.05), there was no significant difference in complications between the two groups (P>0.05).Conclusion Pulmonary surfactant combined with BiPAP can effectively improve the oxygenation function and lungfunction in children with RDS, and it is safe in clinical application.