无创高频振荡通气对新生儿呼吸衰竭外周血 CC16 与KL-6 表达的影响

Effect of nHFOV on the level of CC16 and KL-6 in neonatal acute respiratory failure

摘要:

目的 探究无创高频振荡通气对新生儿呼吸衰竭外周血Clara 细胞蛋白16（CC16）与Ⅱ型肺泡 表面抗原6（KL-6）表达的影响。方法 选取2015 年1 月—2017 年12 月于邯郸市第一医院就诊的208 例呼 吸衰竭新生儿作为研究对象，依照随机数字表法将患儿分成观察组和对照组。观察组采用无创高频振荡通气 治疗，对照组采用同步间歇指令通气治疗，比较两组的临床疗效，并检测两组患儿机械通气后0、24 和72 h 血气指标、治疗前后血清CC16 及KL-6 的变化和并发症的发生情况。结果 观察组总有效率高于对照组 （P <0.05），观察组临床疗效优于对照组（P <0.05）。观察组机械通气后的氧合指数、呼吸指数、吸入气氧浓 度（FiO2）和动脉血二氧化碳分压（PaCO2）低于对照组（P <0.05），而动脉血氧分压（PaO2）、PaO2/FiO2 高 于对照组（P <0.05）。观察组与对照组治疗后72 h 血清CC16 和KL-6 均低于治疗前（P <0.05）。观察组治 疗后72 h 的CC16 与KL-6 低于对照组（P <0.05）。观察组机械通气时间、住院时间低于对照组（P <0.05）。 观察组呼吸机相关性肺炎、并发症总发病率低于对照组（P <0.05）。结论 无创高频振荡通气治疗新生儿呼 吸衰竭的疗效更佳，能够显著改善患儿血气指标，减轻炎症反应，降低患儿CC16、KL-6 水平。

Abstract:

Objective To explore the effect of noninvasive high frequency oscillatory ventilation on Clara cell protein 16 and KL-6 expression in neonatal respiratory failure. Methods A total of 208 cases of neonates from January 2015 to December 2017 in our hospital with respiratory failure were randomly divided into observation group and control group. The observation group was treated with noninvasive high frequency oscillatory ventilation, while the control group was treated with synchronized intermittent mandatory ventilation. The blood gas indexes at 0h, 24h and 72h of two groups were detected, and the changes of serum CC16 and KL-6 before and after treatment and the occurrence of adverse reactions were observed. Results After treatment, the total effective rate in the observation group was higher than the control group (P < 0.05). The effect of the observation group was better than that of the control group (P < 0.05). The oxygenation index, respiratory index, inhaled oxygen concentration (FiO2) and arterial partial pressure of carbon dioxide (PaCO2) in the observation group were lower than those in the control group (P < 0.05), while arterial partial pressure of oxygen (PaO2) and PaO2/FiO2 were higher than those in the control group (P < 0.05). The levels of serum CC16 and KL-6 in the observation group and the control group were lower 72 hours after treatment (P < 0.05). The CC16 and KL-6 in the observation group were lower than those in the control group 72 hours after treatment (P < 0.05). The time of mechanical ventilation and hospitalization in the observation group was lower than that in the control group (P < 0.05). The total incidence rate of ventilator-associated pneumonia and complications in the observation group was lower than that in the control group (P < 0.05). Conclusion Noninvasive high frequency oscillatory ventilation in the treatment of neonatal with respiratory failure can significantly improve the blood gas index, reduce inflammation, reduce the level of KL-6 and CC16, with less adverse reaction.