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目的探讨高频振荡通气联合猪肺磷脂注射液治疗新生儿呼吸窘迫综合征的临床疗效及对血气分析指标影响。方法选择2010年1月—2014年10月于陕西省咸阳市第一人民医院住院的新生儿呼吸窘迫综合征患儿78例,按照随机数字表法分为对照组和观察组,每组39例。对照组患儿给予高频振荡通气治疗,观察组患儿在高频振荡通气基础上加用猪肺磷脂注射液。比较两组患儿的临床疗效,治疗前及治疗后1、6、12、24 h呼吸频率、心率、舒张压及血气分析指标〔动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、p H值〕,观察治疗过程中两组患儿不良反应发生情况。结果观察组患儿临床疗效优于对照组(u=1.789,P=0.037)。治疗前两组患者呼吸频率、心率、舒张压比较,差异无统计学意义(P>0.05);治疗后1、6、12、24 h观察组患儿呼吸频率、心率低于对照组,舒张压高于对照组(P<0.05)。治疗前两组患儿PaO2、PaCO2、p H值比较,差异无统计学意义(P>0.05);治疗后1、6、12、24 h观察组患儿PaO2、p H值高于对照组,PaCO2低于对照组(P<0.05)。对照组2例患儿、观察组3例患儿出现轻度二氧化碳潴留。结论高频振荡通气联合猪肺磷脂注射液治疗新生儿呼吸窘迫综合征的临床疗效确切,可有效改善患儿的血气分析指标。
Objective To investigate the clinical efficacy of high-frequency oscillatory ventilation combined with porcine pulmonary phospholipid in the treatment of neonatal respiratory distress syndrome and its influence on blood gas analysis index. Methods From January 2010 to October 2014, 78 children with neonatal respiratory distress syndrome admitted to the First People’s Hospital of Xianyang City, Shaanxi Province were divided into control group and observation group according to the random number table method, with 39 cases in each group . The control group of children given high-frequency oscillatory ventilation treatment, observation group of children on the basis of high-frequency oscillatory ventilation plus pulmonary phlebitis injection. The clinical efficacy, respiratory rate, heart rate, diastolic blood pressure and indexes of blood gas analysis before and after treatment were compared (PaO2, PaCO2 ), P H value〕 observed two groups of children during treatment adverse reactions. Results The clinical efficacy of observation group was better than that of control group (u = 1.789, P = 0.037). There was no significant difference in respiratory rate, heart rate and diastolic blood pressure between the two groups before treatment (P> 0.05). The respiratory rate and heart rate of the observation group were lower than those of the control group at 1, 6, 12 and 24 hours after treatment Higher than the control group (P <0.05). The PaO2, PaCO2 and p H values in the two groups before treatment were not significantly different (P> 0.05). PaO2 and p H values in the observation group were higher than those in the control group at 1, 6, 12 and 24 hours after treatment PaCO2 was lower than the control group (P <0.05). Two patients in the control group and three patients in the observation group had mild carbon dioxide retention. Conclusion High-frequency oscillatory ventilation combined with pulmonary phlebitis injection treatment of neonatal respiratory distress syndrome clinical efficacy is exact, can effectively improve children’s blood gas analysis indicators.