| 王立云,郝 丽,陶名玉,申 璐,殷其改.HFOV联合PS对治疗新生儿ALI/ARDS的疗效及对肺动态顺应性的影响[J].,2021,(17):3325-3330 |
| HFOV联合PS对治疗新生儿ALI/ARDS的疗效及对肺动态顺应性的影响 |
| Effect of HFOV Combined with PS in Treatment of Neonatal ALI/ARDS and Its Effects on Dynamic Lung Compliance |
| 投稿时间：2021-02-03 修订日期：2021-02-27 |
| DOI：10.13241/j.cnki.pmb.2021.17.027 |
| 中文关键词: 新生儿 急性肺损伤 急性呼吸窘迫综合征 高频振荡通气 肺表面活性物质 肺动态顺应性 |
| 英文关键词: Acute lung injury Acute respiratory distress syndrome High frequency oscillatory ventilation Pulmonary surfactant Pulmonary dynamic compliance |
| 基金项目:江苏省自然科学基金项目（BK2015144） |
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| 中文摘要: |
| 摘要 目的：探讨高频振荡通气（HFOV）联合肺表面活性物质（PS）对治疗新生儿急性肺损伤/急性呼吸窘迫综合征（ALI/ARDS）的疗效及对肺动态顺应性的影响。方法：选择2018年1月至2020年12月我院新生儿科收治的160例ALI/ARDS患儿进行研究，按照随机数表法分为观察组和对照组，每组80例。对照组患儿给予常频通气（CMV）模式联合PS治疗，观察组患儿给予HFOV模式联合PS治疗。比较两组患儿一般治疗情况、治疗前后肺动态顺应性、动脉血氧分压（PaO2）、动脉二氧化氮分压（PaCO2）、氧合指数（OI）、血清肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、IL-10的变化，以及治疗期间并发症发生情况。结果：观察组胸片恢复正常时间、机械通气时间、氧暴露时间、ICU停留时间、住院时间结果均明显短于对照组（P＜0.05），两组患儿病死率相比较，无统计学意义（P＞0.05）；治疗后12 h、24 h、48 h时，观察组肺动态顺应性及PaO2、OI结果明显高于对照组，PaCO2明显比对照组低，差异有统计学意义（P＜0.05）；治疗后48 h时，观察组血清TNF-α、IL-6水平均明显低于对照组，IL-10明显比对照组高，差异有统计学意义（P＜0.05）；两组治疗期间，呼吸机相关性肺损伤、颅内出血、气漏、呼吸道感染的总发生率比较，无统计学意义（P＞0.05）。结论：HFOV联合PS治疗新生儿ALI/ARDS疗效明显，可有效改善患儿肺动态顺应性，促进血气分析指标恢复，且可降低炎症因子的表达，值得推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of high frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) in treatment of neonatal acute lung injury/acute respiratory distress syndrome (ALI / ARDS) and its effects on dynamic lung compliance. Methods: 160 children with ALI/ARDS in our hospital from January 2018 to December 2020 were selected, they were randomly divided into observation group and control group, 80 cases in each group. The control group was treated with constant frequency ventilation (CMV) mode combined with PS, and the observation group was treated with HFOV mode combined with PS. The general treatment, the changes of the pulmonary dynamic compliance, arterial partial pressure of oxygen (PaO2), arterial partial pressure of nitrogen dioxide (PaCO2), oxygenation index (OI), serum blood gas tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-10 before and after treatment, and complications during treatment were compared between the two groups. Results: The results of chest X-ray recovery time, mechanical ventilation time, oxygen exposure time, ICU stay time and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05); There was no statistical significance in the mortality rate between the two groups (P＞0.05); At after treatment 12 h, 24 h and 48 h, the results of pulmonary dynamic compliance, PaO2 and OI in the observation group were significantly higher than those in the control group, and PaCO2 in the observation group was significantly lower than that in the control group, with statistically significant(P<0.05); At after treatment 48 h, the serum TNF-α and IL-6 levels in the observation group were significantly lower than those in the control group, and the IL-10 levels in the observation group were significantly higher than those in the control group with statistically significant(P<0.05); There was no statistical significance in the total incidence of ventilator-related lung injury, intracranial hemorrhage, air leakage and respiratory tract infection in the two groups(P＞0.05). Conclusion: HFOV combined with PS have obvious curative effect in the treatment of neonatal ALI/ARDS, which can effectively improve the dynamic compliance of lung, promote the recovery of blood gas analysis indexes, and reduce the expression of inflammatory factors, which is worthy of popularization and application. |
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