高频振荡通气联合肺表面活性物质对NRDS患儿血流动力学、氧合功能及炎症因子水平的影响

目的:探讨高频振荡通气(HFOV)联合肺表面活性物质(PS)对新生儿呼吸窘迫综合征(NRDS)血流动力学、氧合功能及炎症因子水平的影响。方法:选取2016年6月~2019年4月期间我院接收的129例NRDS患儿,按照随机数字表法将患儿分为研究组(n=65)、对照组(n=64),均给予PS治疗,在此基础上,对照组患儿给予常频机械通气(CMV)治疗,研究组给予HFOV治疗,比较两组患儿疗效、血流动力学、氧合功能、炎症因子水平及并发症发生情况。结果:研究组治疗24h后的临床总有效率为89.23%(58/65),高于对照组的68.75%(44/64)(P<0.05)。两组患儿治疗24h后动脉血氧分压(PaO2)升高,且研究组高于对照组(P<0.05);心率(HR)、肺动脉压(PAP)、白介素-6(IL-6)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、动脉二氧化碳分压(PaCO2)、氧合指数(OI)均下降,且研究组低于对照组(P<0.05)。两组并发症总发生率比较差异无统计学意义(P>0.05)。结论:HFOV联合PS治疗NRDS可有效改善患儿血流动力学、氧合功能及炎症因子水平,且不增加并发症发生率,临床应用价值较高。

Effects of High Frequency Oscillatory Ventilation Combined with Pulmonary Surfactant on Hemodynamics, Oxygenation and Inflammatory Factors in NRDS Children

ABSTRACT Objective: To investigate the effects of high frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) on hemodynamics, oxygenation and inflammatory factors in neonates with respiratory distress syndrome (NRDS). Methods: A total of 129 cases of neonates with NRDS in our hospital from June 2016 to April 2019 were selected. According to the method of random number table, they were divided into the control group (n=64) and study group (n=65). All the patients were given PS treatment. On this basis, the children in the control group were given conventional mechanical ventil (CMV) treatment, and the study group was given HFOV treatment. The therapeutic effect, hemodynamics, oxygenation, inflammatory factors and complications were compared between the two groups. Results: The total clinical effective rate of the study group at 24h after treatment was 89.23% (58/65), which was higher than 68.75% (44/64) of the control group (P<0.05). The arterial partial pressure of oxygen (PaO²) increases, and that in the study group was higher than that in the control group (P<0.05). The heart rate (HR), pulmonary artery pressure (PAP), interleukin-6 (IL-6), procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), arterial partial pressure of carbon dioxide (PaCO²), oxygenation index (OI) decreased in the two groups at 24h after treatment, and those in the study group were lower than those in the control group (P<0.05). There was no significant difference in the total incidence of complications between the two groups (P>0.05). Conclusion: HFOV combined with PS is effective in the treatment of NRDS. It can effectively improve the hemodynamics, oxygenation and inflammatory factors in children, and it does not increase the incidence of complications. It has a high clinical value.