摘要
目的探讨肺表面活性物质(pulmonary surfactant,PS)联合枸橼酸咖啡因对同步鼻塞间歇正压通气(synchronized nasal intermittent positive pressure ventilation,SNIPPV)治疗新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)疗效的影响。方法回顾性分析2016年1月至2019年6月中国医科大学附属盛京医院新生儿重症监护室接受治疗的确诊为NRDS且需要SNIPPV治疗的新生儿99例,分为联合组(PS+枸橼酸咖啡因)46例,对照组为单独应用PS 53例。比较两组患儿呼吸机使用时间、用氧时长、住院时间、临床效果及并发症。结果联合组呼吸机使用时间、用氧时长及住院时间明显短于对照组,差异有统计学意义(P<0.05)。联合组治疗期间支气管肺发育不良发生率低于对照组,差异有统计学意义(P<0.05),新生儿坏死性小肠结肠炎、呼吸机相关性肺炎、肺出血及败血症、胃肠功能紊乱、心律失常等并发症的发生率两组比较差异无统计学意义(P>0.05)。结论PS联合枸橼酸咖啡因对于接受SNIPPV治疗的NRDS患儿可改善肺功能,缩短呼吸机使用时间,减少用氧时长,提高存活率,降低并发症,值得推荐及推广应用。
Objective To investigate the clinical effects of pulmonary surfactant(PS) combined with caffeine citrate on neonatal respiratory distress syndrome(NRDS) treated with synchronized nasal intermittent positive pressure ventilation(SNIPPV). Methods We collected and analyzed 99 neonates who were diagnosed with NRDS and required SNIPPV treatment from January 2016 to June 2019 in NICU of Shengjing Hospital of China Medical University.According to the different treatment, they were divided into PS+ citrate caffeine combination group and control group.The control group(53 neonates)was treated by PS alone.The combination group(46 neonates)was treated with PS combined with caffeine citrate.The indexes of ventilator time, the time of using oxygen, length of hospital stay and complications were compared between the two groups. Results The indexes of ventilator time, the time of using oxygen and length of hospital stay of combination group were significantly shorter than those of the control group.The differences were statistically significant(P<0.05). However, the incidences of ventilator associated pneumonia, gastrointestinal dysfunction, arrhythmia and other complications were not significantly different between the two groups(P>0.05). Conclusion PS combined with caffeine citrate in the treatment of NRDS with SNIPPV could effectively improve the pulmonary function of infants.It could improve the neonatal survival rate and reduce complications.It is worth to be recommended.
作者
刘畅
张舒晴
岳冬梅
Liu Chang;Zhang Shuqing;Yue Dongmei(Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China;School of Pharmacy of China Medical University, Shenyang 110122, China)
出处
《中国小儿急救医学》
CAS
2019年第9期671-675,共5页
Chinese Pediatric Emergency Medicine
基金
辽宁省自然科学基金项目(201602873)
辽宁省省直医院改革重点临床科室诊疗能力建设项目(LNCCC-D08-2015).
关键词
新生儿呼吸窘迫综合征
同步鼻塞间歇正压通气
肺表面活性物质
枸橼酸咖啡因
Neonatal respiratory distress syndrome
Synchronized nasal intermittent positive pressure ventilation
Pulmonary surfactant
Caffeine citrate
