容量目标通气联合肺泡表面活性物质治疗新生儿 呼吸窘迫综合征的疗效分析

Efficacy of pulmonary surfactant combined with volume target ventilation on the treatment of neonatal respiratory distress syndrome

摘要:

目的 探讨肺泡表面活性物质联合容量目标通气治疗新生儿呼吸窘迫综合征（NRDS）的疗效。 方法 选取2014 年1 月—2017 年3 月资阳市第一人民医院收治的NRDS 患儿42 例，参照随机数字表法将 患儿分为对照组及研究组。对照组患儿接受常规治疗+ 容量目标通气治疗，研究组患儿接受常规治疗+ 容量 目标通气+ 肺泡表面活性物质治疗。比较两组患儿治疗前及治疗1 周后动脉血气指标水平、Th1/Th2 细胞 因子含量及心肌损伤标志物含量的差异。结果 两组治疗1 周后的动脉血氧分压（PaO2）、氧合指数（OI）、 血氧饱和度（SpO2）及血清白细胞介素-4（IL-4）较治疗前升高（P <0.05），而二氧化碳分压（PaCO2）、 血清干扰素-γ（IFN-γ）、肌钙蛋白Ⅰ（cTnI）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）含量 及IFN-γ/IL-4 水平较治疗前降低（P <0.05）。研究组患儿治疗1 周后PaO2、OI、SpO2 及IL-4 较对照 组升高（P <0.05），而PaCO2、IFN-γ、IFN-γ/IL-4、cTnI、CK-MB 及LDH 较对照组降低（P <0.05）。 结论 NRDS 患儿接受肺泡表面活性物质联合容量目标通气治疗，可有效优化通气功能并减轻全身炎症状态， 抑制心肌损伤。

Abstract:

Objective To study the effect of pulmonary surfactant combined with volume target ventilation in the treatment of neonatal respiratory distress syndrome (NRDS). Methods A total of 42 cases of NRDS in our hospital during January 2014 to March 2017 were chosen as research subject, and all patients were divided into control group and study group each with 21 cases according to the random number table method. Patients in control group were treated with routine treatment + volume target ventilation (VTV) treatment, and those in study group were treated with routine treatment + VTV + pulmonary surfactant. The differences of arterial blood gas indexes, Th1/Th2 cytokine contents and myocardial damage markers were compared between two groups before and after one-week treatment. Results After one week of treatment, the arterial partial pressure of oxygen (PaO2), oxygenation index (OI), blood oxygen saturation (SpO2) and serum interleukin-4 (IL-4) levels of two groups increased, while the partial pressure of carbon dioxide (PaCO2) and serum interferon-γ (IFN-γ), troponin I (cTnI), creatine kinase isoenzyme (CKMB) contents and IFN-γ/IL-4 level decreased (P < 0.05). Compared with the control group, the elevation of PaO2, OI, SpO2 and IL-4 were higher (P < 0.05), and PaCO2, IFN-γ, IFN-γ/IL-4, cTnI, CK-MB and LDH were significantly increased in the observation group one week after treatment (P < 0.05). Conclusions The treatment of NRDS with pulmonary surfactant combines with VTV can effectively optimize the ventilation function, and reduce the state of systemic inflammation and inhibit myocardial injury.