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不同机械通气方式治疗新生儿呼吸衰竭的效果及对患儿CC16、KL-6水平的影响 预览

Effect of different mechanical ventilation on neonatal respiratory failure and the levels of CC16 and KL-6 in neonates
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摘要 目的探讨有创高频振荡通气和同步间歇指令通气治疗新生儿呼吸衰竭的临床疗效及对患儿CC16、KL-6水平的影响。方法选取呼吸衰竭患儿130例,按随机数字表法将其分为观察组65例(其中足月儿53例,早产儿12例)和对照组65例(其中足月儿50例,早产儿15例)。观察组采用有创高频振荡通气治疗,对照组采用同步间歇指令通气治疗,比较2组早产儿和足月儿的临床疗效,并检测2组机械通气0 h、24 h和72 h血气指标氧合指数(oxygenation index,OI)、呼吸指数(respiratory index,RI)、二氧化碳分压(pressure of carbon dioxide,PaCO2)、氧分压(oxygen partial pressure,PaO2)、动脉氧分压与吸入氧浓度比(oxygen partial pressure/fraction of inspiration O 2,PaO2/FiO2),治疗前后血清CC16及KL-6变化情况和不良反应发生率。结果观察组总的临床有效率为90.8%(59/65),明显高于对照组的80.0%(52/65)(P<0.05)。2组足月儿治疗有效率优于早产儿(P<0.05)。观察组经口喂养时间、呼吸机使用时间和住院时间明显短于对照组(P<0.05)。机械通气后2组OI、RI和PaCO2均呈逐渐下降趋势,2组PaO 2和PaO2/FiO2均呈逐渐升高趋势,但观察组降低和升高的幅度更大,2组在组间、时点间以及组间·时点间交互作用差异均有统计学意义(P<0.05)。2组血清CC16和KL-6均较治疗前明显降低(P<0.05),治疗后观察组CC16和KL-6水平均明显低于对照组(P<0.05)。观察组肺出血、呼吸机相关性肺炎、下呼吸道感染等不良反应发生率均明显低于对照组(P<0.05)。结论有创高频振荡通气治疗新生儿呼吸衰竭的疗效更佳,能够明显改善患儿血气指标,减缓炎症作用,从而降低患儿CC16、KL-6水平,改善肺部损伤,不良反应较少。 Objective To explore the clinical efficacy of high frequency oscillatory ventilation and synchronized intermittent mandatory ventilation in the treatment of neonatal respiratory failure,and the influence on the levels of CC16 and KL-6 in neonates.Methods One hundred and thirty cases of neonates with respiratory failure were randomly divided into observation group(n=65,12 cases of premature infants,53 cases of full-term infants)and control group(n=65,12 cases of premature infants,53 cases of full-term infants).The observation group was treated with high frequency oscillatory ventilation,the control group was treated with synchronized intermittent mandatory ventilation,The clinical efficacy of two groups of preterm infants and full-term infants were compared,and the 0 h,24 h and 72 h blood gas indexes of two groups were detected,and the changes of serum CC16 and KL-6 before and after treatment and the occurrence of adverse reactions were observed.Results The overall clinical effective rate was 90.8%(59/65)in the observation group,which was significantly higher than that in the control group(80.0%,52/65).The effective rate of the two groups of full-term infants was better than that of premature infants(P<0.05).The oral feeding time,ventilator use time and hospitalization time of the observation group were significantly shorter than the control group(P<0.05).After mechanical ventilation,the OI,RI and PaCO 2 of the two groups showed a gradual decline trend.The PaO 2 and PaO 2/FiO 2 of the two groups showed a gradual increase,but the decrease and increase of the observation group were larger.The two groups were between the groups and the time.There were significant differences in the interaction between the groups and between the groups(P<0.05).The serum levels of CC16 and KL-6 in the two groups were significantly lower than those before treatment(P<0.05).The levels of CC16 and KL-6 in the observation group were significantly lower than those in the control group after treatment(P<0.05).The incidence of adverse reactio
作者 原静 李书芳 李亚菲 郎元法 王莎 YUAN Jing;LI Shu-fang;LI Ya-fei;LANG Yuan-fa;WANG Sha(Department of Neonatology,the First Hospital of Handan,Hebei Province,Handan 056000,China;The Second Department of Pediatric,the First Hospital of Handan,Hebei Province,Handan 056000,China;Department of Pediatric,the Second Hospital of Handan,Hebei Province,Handan 056000,China;The Second Department of Neurologist,the First Hospital of Handan,Hebei Province,Handan 056000,China)
出处 《河北医科大学学报》 CAS 2019年第5期551-555,共5页 Journal of Hebei Medical University
基金 河北省医学科学研究重点课题(20171111).
关键词 呼吸功能不全 婴儿 新生 呼吸 人工 治疗结果 respiratory insufficiency infant,newborn respiration,artificial treatment outcome
作者简介 原静(1983-),女,河北邯郸人,河北省邯郸市第一医院主治医师,医学硕士,从事新生儿疾病诊治研究。
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