文章摘要
汪 燕,鲁利群,杨 欣,吕 洁,樊 扬.微创肺表面活性物质对呼吸窘迫综合征新生儿肝肾功能、氧合功能及呼吸功能的影响[J].,2020,(16):3138-3142
微创肺表面活性物质对呼吸窘迫综合征新生儿肝肾功能、氧合功能及呼吸功能的影响
Effects of Minimally Invasive Pulmonary Surfactant on the Liver and Kidney Function, Oxygenation and Respiratory Function of Neonatal Respiratory Distress Syndrome
投稿时间:2020-01-23  修订日期:2020-02-18
DOI:10.13241/j.cnki.pmb.2020.16.030
中文关键词: 微创  肺表面活性物质  新生儿呼吸窘迫综合征  氧合功能  肝肾功能  呼吸功能
英文关键词: Minimally invasive  Pulmonary surfactants  Neonatal respiratory distress syndrome  Aerobic function  Hepatorenal function  Respiratory function
基金项目:四川省教育厅科研基金项目(17ZA0118)
作者单位E-mail
汪 燕 成都医学院第一附属医院儿科 四川 成都 610500 wangyan4935@163.com 
鲁利群 成都医学院第一附属医院儿科 四川 成都 610500  
杨 欣 成都医学院第一附属医院儿科 四川 成都 610500  
吕 洁 成都医学院第一附属医院儿科 四川 成都 610500  
樊 扬 成都医学院第一附属医院儿科 四川 成都 610500  
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中文摘要:
      摘要 目的:探讨微创肺表面活性物质(pulmonary surfactant,PS)对呼吸窘迫综合征新生儿氧合功能、肝肾功能及呼吸功能的影响。方法:选择2018年3月至2019年3月我院收治的66例新生呼吸窘迫综合征的患儿作为研究对象,并按照随机数字表法分为观察组(n=33)和对照组(n=33)。对照组患儿采取常规的治疗方式,观察组患儿则在对照组治疗基础上应用微创PS治疗。观察比较两组患儿的动脉血气指标、Ⅱ型肺泡细胞表面抗原(KL-6)、巨噬细胞移动抑制因子-1(MIF-1)、高迁移率族蛋白1(HMGB-1)、肝肾功能、氧合指数及呼吸机参数。结果:治疗后,两组的氧分压(PaO2)、二氧化碳总量(TCO2)、氧饱和度(SaO2)均较治疗前显著增高;且观察组以上指标均高于对照组。两组的Ⅱ型肺泡细胞表面抗原(KL-6)、巨噬细胞移动抑制因子-1(MIF-1)、高迁移率族蛋白1(HMGB-1)均较治疗前显著降低,且观察组的以上指标均低于对照组。两组的谷草转氨酶(AST)、谷丙转氨酶(ALT)、尿素氮(BUN)、肌酐(CRE)水平均较治疗前显著降低,且观察组的以上指标均明显低于对照组。观察两组的呼吸机参数和氧合指数,发现两组的吸入氧浓度(FiO2)、吸气峰压(PIP)、呼吸末正压(PEEP)、氧合指数(PaO2/FiO2,OI)均较治疗前有所改善,且观察组的以上指标均要优于对照组(P<0.05)。结论:应用微创PS治疗新生儿呼吸窘迫综合征的效果显著,能明显改善患儿的动脉血气指标、肝肾功能以及氧合功能,减轻炎症反应,并减少机械通气的参数。
英文摘要:
      ABSTRACT Objective: To study the effects of minimally invasive pulmonary surfactant (PS) on oxygenation, liver function, kidney function and respiratory function of neonatal respiratory distress syndrome. Methods: From March 2018 to March 2019, 66 children with respiratory distress syndrome were selected and divided into observation group (n=33) and control group (n=33) according to the method of random digital table. The children in the control group were treated with routine treatment, while the children in the observation group were treated with minimally invasive PS on the basis of the control group. Arterial blood gas indexes, type II alveolar cell surface antigen (KL-6), macrophage migration inhibitory factor-1 (MIF-1), high mobility group protein 1 (HMGB-1), liver and kidney function, oxygenation index and ventilator parameters were observed and compared between the two groups. Results: After treatment, the partial pressure of oxygen (PaO2), total carbon dioxide (TCO2) and oxygen saturation (SaO2) in both groups were significantly higher than those before treatment, and the above indexes in the observation group were higher than those in the control group. The level of KL-6, MIF-1, HMGB-1 in both groups was significantly lower than that before treatment, and the above indexes in the observation group were lower than those in the control group. The levels of glutamic oxaloacetic transaminase (AST), glutamic pyruvic transaminase (ALT), urea nitrogen (BUN), creatine (CRE) in both groups were significantly lower than those before treatment, and the above indexes in the observation group were significantly lower than those in the control group. The ventilator parameters and oxygenation index of the two groups were observed. It was found that the inhaled oxygen concentration (FiO2), peak inspiratory pressure (PIP), positive end-respiratory pressure (PEEP), and oxygenation index (PaO2/FiO2, OI) in both groups were better than those before treatment, and the above indexes in the observation group were better than those in the control group (P<0.05). Conclusion: Minimally invasive PS is effective in the treatment of neonatal respiratory distress syndrome, which can significantly improve the arterial blood gas index, liver function, kidney function and oxygenation function, reduce the inflammatory reaction and the parameters of mechanical ventilation.
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