牛肺表面活性剂联合枸橼酸咖啡因治疗新生儿呼吸窘迫综合征的早期干预效果及对氧合功能的影响

Early intervention efficacy of bovine pulmonary surfactant combined with caffeine citrate in neonatal respiratory distress syndrome and its impact on oxygenation function

摘要:

目的 探讨牛肺表面活性剂联合枸橼酸咖啡因治疗新生儿呼吸窘迫综合征（NRDS）的早期干预效果及对氧合功能的影响。方法 选取2021年5月—2024年10月亳州市人民医院96例NRDS患儿为研究对象，按照随机数字表法分为对照组（牛肺表面活性剂治疗）与观察组（牛肺表面活性剂联合枸橼酸咖啡因治疗），各48例。比较两组患儿的临床疗效、临床指标、通气及氧合指标、呼吸机参数、支气管肺发育不良情况及并发症发生情况。结果 观察组治疗总有效率高于对照组（P <0.05）。观察组机械通气时间、氧疗时间、呼吸暂停次数均低于对照组（P <0.05）。观察组治疗前后动脉血二氧化碳分压、动脉血氧分压、血氧饱和度、氧合指数差值均大于对照组（P <0.05）。观察组治疗前后吸入氧浓度、吸气峰压、呼气末正压的差值均大于对照组（P <0.05）。观察组支气管肺发育不良总发生率低于对照组（P <0.05）。观察组与对照组并发症总发生率比较，差异无统计学意义（P >0.05）。结论 牛肺表面活性剂联合枸橼酸咖啡因可显著改善NRDS患儿氧合功能，减少支气管肺发育不良情况的发生，且安全性良好，具有临床推广价值。

Abstract:

Objective To investigate the early intervention effect of bovine pulmonary surfactant combined with caffeine citrate on neonatal respiratory distress syndrome (NRDS) and its impact on oxygenation function.Methods A total of 96 infants with NRDS admitted to Bozhou People’s Hospital from May 2021 to October 2024 were randomly assigned to a control group (n = 48, treated with bovine pulmonary surfactant alone) and an observation group (n = 48, treated with bovine pulmonary surfactant plus caffeine citrate). Clinical efficacy, clinical indicators, ventilation and oxygenation indices, ventilator parameters, incidence of bronchopulmonary dysplasia (BPD), and complications were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group (P < 0.05). The observation group had shorter durations of mechanical ventilation and oxygen therapy, as well as fewer apnea episodes compared with the control group (P < 0.05). Differences in arterial partial pressure of carbon dioxide, arterial partial pressure of oxygen, oxygen saturation, and oxygenation index before and after treatment were greater in the observation group than in the control group (P < 0.05). Differences in fraction of inspired oxygen, peak inspiratory pressure, and positive end-expiratory pressure before and after treatment were also greater in the observation group (P < 0.05). The incidence of BPD in the observation group was lower than that in the control group (P < 0.05). There was no significant difference in the overall incidence of adverse events between the two groups (P > 0.05).Conclusion The combination of bovine pulmonary surfactant and caffeine citrate significantly improves oxygenation function, reduces BPD incidence, and demonstrates favorable safety in NRDS infants, supporting its clinical application.