CPAP联合肺表面活性物治疗新生儿呼吸窘迫综合征的临床疗效及对患者血气指标的影响

目的:探讨CPAP(Continuous Positive Airway Pressure)联合肺表面活性物质治疗新生儿呼吸窘迫综合征(NRDS)临床疗效及对血气指标的影响。方法:选择2014年8月至2018年8月本院收治的新生儿呼吸窘迫综合征患者200例,将其随机分为2组,每组100例。A组给予CPAP(持续正压通气)联合肺表面活性物质治疗,B组给予CPAP(持续正压通气)治疗,分析和比较两组的临床疗效及治疗前后血气指标的变化。结果:治疗后,两组新生儿患者PaO_2均较治疗前均显著升高,PaCO_2较治疗前明显降低,且A组PaO_2显著高于B组(P0.05),PaCO_2显著低于B组(P0.05);A组住院时间显著短于B组(P0.05),临床总有效率显著高于B组(P0.05);两组新生儿患者的胸部X线评分均较治疗前显著降低(P0.05),A组12 h和24 h胸部X线评分均显著性低于B组(P0.05);A组PEEP/cmH_2O水平显著低于B组(P0.05),Fi O_2水平显著高于B组(P0.05);两组生儿患者的的OI指数均较治疗前显著升高,且A组明显高于B组(P0.05)。结论:CPAP联合肺表面活性物质治疗NRDS的临床效果显著优于单用CPAP(持续正压通气)治疗,且且可显著改善患儿血气指标。

Clinical Efficacy of CPAP Combined with Pulmonary Surface Active Substances in the Treatment of NRDS and Its Effect on the Blood Gas Indexes

ABSTRACT Objective: The study was designed to investigate the effect of dual-level CPAP combined with pulmonary surfactant on oxidative stress and blood gas index of neonatal respiratory distress syndrome. Methods: In our hospital from August 2014 to August 2018, 200 cases of neonatal respiratory distress syndrome patients were treated, randomly divided into two groups. The group A were treated with double-level CPAP (double-level positive pressure ventilation) combined with pulmonary surfactant. The group B were treated with pulmonary surfactant. To analyze and compare the results of oxidative stress between the two groups and its effect on blood gas index. Results: After treatment, PaO₂ levels was significantly increased in both groups compared with that before treatment, and PaCO₂ levels was significantly decreased in both groups. Meanwhile, it was found that the increased level of PaO₂ in group A was significantly better than that in group B, and the decreased level of PaCO₂ in group A was significantly better than that in group B. The length of hospital stay in group A was significantly shorter than that in group B, and the clinical effect in group A was significantly better than that in group B. After treatment, the chest X-ray scores of neonates in both groups A and B were significantly reduced, among which the chest X-ray scores at 12 h and 24 h in group A were significantly lower than those in group B. After treatment, the decreased level of PEEP/cmH₂O in group A was significantly higher than that in group B; after treatment, the decreased level of FiO₂ in group A was significantly lower than that in group B (P<0.05); after treatment, the OI index of the two groups was significantly increased, and the significance of group A was significantly higher than that of group B (P<0.05). Conclusion: The clinical effect of dual level CPAP combined with pulmonary surfactant on neonatal respiratory distress syndrome was significant, and the blood gas indexes had significant changes.