摘要
目的探讨双水平正压通气(BiPAP)联合外源性肺表面活性物质治疗新生儿呼吸窘迫综合征(NRDS)的疗效及对免疫功能的影响。方法选择2015年1月至2018年12月收治的80例NRDS患儿,随机分为对照组和研究组,每组40例。对照组给予外源性肺表面活性物质治疗,研究组给予BiPAP联合外源性肺表面活性物质治疗。比较2组临床疗效。比较2组治疗前与治疗48 h后的平均气道压力(MAP)、呼气末正压(PEEP)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数(SaO2)及Th细胞、Ts细胞、B细胞及NK细胞水平。比较2组患儿治疗过程中不良反应的发生情况。结果研究组总有效率为92.50%(37/40),对照组为75.00%(30/40),2组差异有统计学意义(χ^2=4.501,P=0.034)。2组治疗前MAP、PEEP、PaO2、PaCO2及SaO2差异均无统计学意义(P>0.05);治疗后,2组MAP、PEEP、PaCO2均明显小于治疗前,PaO2、SaO2均明显大于治疗前,且研究组MAP、PEEP、PaO2、PaCO2及SaO2的变化幅度均明显大于对照组,差异均有统计学意义(P<0.05)。2组治疗前Th细胞、Ts细胞、B细胞及NK细胞测定值差异均无统计学意义(P>0.05);治疗后,2组B细胞、NK细胞测定值均明显大于治疗前(P<0.05),Th细胞、Ts细胞测定值均大于治疗前,但差异无统计学意义(P>0.05),且研究组B细胞、NK细胞测定值均明显大于对照组(P<0.05),研究组Th细胞、Ts细胞测定值均大于治疗前,但差异无统计学意义(P>0.05)。研究组的并发症发生率为10.00%,对照组为5.00%,差异无统计学意义(χ^2=0.721,P=0.396)。结论BiPAP联合外源性肺表面活性物质治疗NRDS的临床疗效显著,能够明显改善肺部功能和血气指标,改善免疫功能,且安全性较好。
Objective To investigate the clinical efficacy of bilevel positive airway pressure(BiPAP)combined with exogenous pulmonary surfactant in treatment of neonatal respiratory distress syndrome(NRDS)and its effects on the immune function of patients.Methods A total of 80 children patients with NRDS who were treated in our hospital from January 2015 to December 2018 were enrolled in the study,who were divided into control group and experiment group,with 40 patients in each group.The patients in control group were treated by exogenous pulmonary surfactant,however,the patients in experiment group were treated by BiPAP combined with exogenous pulmonary surfactant.The clinical efficacy,and the MAP,PEEP,PaO2,PaCO2,SaO2,Th cells,Ts cells,B cells,NK cells before treatment and at 48h after treatment were observed and compared between the two groups.Moreover the incidence rate of adverse reactions during treatment was observed and compared between the two groups.Results The total effective rate in experiment group was 92.50%(37/40),which was significantly higher than that[75.00%(30/40)]in control group(P<0.05).Before treatment there were no significant differences in the MAP,PEEP,PaO2,PaCO2,SaO2 betweeen the two groups(P>0.05).After treatment,the levels of MAP,PEEP,PaCO2 in both groups were significantly decreased(P<0.05),however,thelevels of PaO2,SaO2 were significantly increased in both groups,moreover,the changes of the indexes mentioned above in experiment group were more significant than those in control group(P<0.05).Before treatment there were no significant differences in the levels of Th cells,Ts cells,B cells,NK cells between the two groups(P>0.05).After treatment,the levels of B cells,NK cells were significantly increased in both groups(P<0.05),and the levels of Th cells,Ts cells were increased,but there were no significant differences before treatment and after treatment(P>0.05).Moreover the levels of B cells and NK cells in experiment group were significantly higher thanthose in control group(P<0.05).After treatmentthe levels of Th cells and Ts cells in experiment groupwere higher than those before treatment,but therewere no significant differences before treatment andafter treatment(P>0.05).In addition the incidencerate of adverse reactions in experiment group was10.00%,which was 5.00%in control group,therewas no significant difference between the two groups(P>0.05).Conclusion BiPAP combined with exogenous pulmonary surfactant in treatment of NRDS has significant therapeutic effects,which can improve the lung function,blood gas indexes and immune function of patients,with good safety.
作者
蒋志红
殷其改
陆世娟
JIANG Zhihong;YIN Qigai;LU Shijuan(Neonatal Department,People’s Hospital of Ganyu District of Lianyungang City,Jiangsu, Lianyungang 222100,China)
出处
《河北医药》
CAS
2020年第14期2141-2144,共4页
Hebei Medical Journal
关键词
新生儿呼吸窘迫综合征
双水平正压通气
外源性肺表面活性物质
治疗结果
免疫功能
neonatal respiratory distress syndrome
bilevel positive airway pressure
exogenous pulmonary surfactant
treatment outcome
immune function
