目的 分析高频振荡通气(high-frequency oscillatory ventilation，HFOV)联合牛肺表面活性剂对重症新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome，NRDS)早产儿血气指标及并发症的影响。方法 回顾性选取90例重症NRDS早产儿，均为周口市中心医院2022年1月至2022年12月所收治，按照不同的治疗方案将全部早产儿分成两组，对照组与观察组各45例;其中对照组早产儿接受牛肺表面活性剂联合常规机械通气治疗，而观察组早产儿则接受牛肺表面活性剂联合HFOV治疗;观察比较两组的血清氨基末端B型脑钠肽前体(amino-terminal pro-b-type natriuretic peptide precursor，NT-proBNP)、降钙素原(procalcitonin，PCT)水平、血气指标水平、并发症发生情况。结果 观察组治疗后48 h的NT-proBNP、PCT水平显著低于对照组(P＜0。05)。观察组治疗后48 h 的动脉血氧分压(arterial partial pressure of oxygen，PaO2)、氧合指数(oxygenation Index，OI)水平均显著高于对照组，吸入氧浓度(fraction of inspired oxygen，FiO2)水平则显著低于对照组，比较差异有统计学意义(P＜0。05)。在并发症发生率方面，两组比较差异无统计学意义(P＞0。05)。观察组机械通气时间、氧疗时间和住院时间较对照组短，差异有统计学意义(P＜0。05)。结论 在对重症NRDS早产儿进行治疗时，采用HFOV联合牛肺表面活性剂治疗能让血清NT-proBNP、PCT水平有效降低，对血气指标水平进行显著改善，而且显著缩短早产儿机械通气时间、氧疗时间和住院时间。具有较高的安全性，值得推广。
Effect of HFOV combined with bovine lung surfactant therapy on blood gas indicators and complications in premature infant with severe NRDS
Objective To analyze the effect of high-frequency oscillatory ventilation(HFOV)combined with bovine lung surfactant on blood gas indicators and complications in premature infants with severe neonatal respiratory distress syndrome(NRDS).Methods Totally 90 premature infants with severe NRDS were retrospectively selected,all of whom were admitted to Zhoukou Central Hospital from January 2022 to December 2022.According to different treatment plans,all premature infants were divided into two groups,with 45 cases in the control group and 45 cases in the observation group;the control group received bovine lung surfactant combined with conventional mechanical ventilation treatment,while the observation group received bovine lung surfactant combined with HFOV treatment;the levels of serum amino terminal pro-b-type natriuretic peptide precursor(NT-proBNP),procalcitonin(PCT),blood gas index and compli-cations were observed and compared between the two groups.Results The NT-proBNP and PCT levels in the observa-tion group were significantly lower than those in the control group at 48 h after treatment(P＜0.05).The arterial partial pressure of oxygen(PaO2)and oxygenation index(OI)levels in the observation group were significantly higher than those in the control group 48 h after treatment,while the fraction of inspiration O2(FiO2)level was significantly lower than that in the control group,with a statistically significant difference(P＜0.05).There was no statistically significant difference in the incidence of complications between the two groups(P＞0.05).Mechanical ventilation time,oxygen therapy time and hospitalization time were shorter in the observation group than those in the control group,and the differ-ence was statistically significant(P＜0.05).Conclusion When treating premature infants with severe NRDS,the com-bination of HFOV and bovine lung surfactant therapy can effectively reduce serum NT proBNP,PCT levels,significantly improve blood gas indicators,and decrease mechanical ventilation time,oxygen therapy time and hospitalization time.It has high safety and is worth promoting.
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