NCPAP对新生儿胎粪吸入综合征合并呼吸衰竭患儿血清炎症因子的影响-现代医学

NCPAP对新生儿胎粪吸入综合征合并呼吸衰竭患儿血清炎症因子的影响

单位：山东省聊城市东昌府区妇幼保健院

分类号：

出版年·卷·期（页码）：2016·44·第一期（114-117）

摘要：

目的：探讨经鼻持续气道正压通气（NCPAP）对新生儿胎粪吸入综合征合并呼吸衰竭患儿血清炎症因子的影响。方法：将本院²0¹³年³月至²0¹5年³月期间收治的40例新生儿MAS合并呼吸衰竭患儿随机分为两组进行临床观察，每组各²0例，对照组给予常规有创经气管内插管机械进行通气，观察组给予NCPAP呼吸通气。观察患儿治疗前后临床症状变化及并发症等情况，记录治疗前后PâO²、PâCO²、SâO²、血清IL-¹、IL-6及ÞNF-α水平变化情况。结果：观察组患儿治疗有效率95.0%明显高于对照组65.0%（=³.9¹，P=0.048），对照组患儿出现气胸者¹例，肺出血者¹例，纵隔气肿¹例，肺并发症发生率为¹5%。观察组患儿¹例出现气胸现象，并发症发生率为5.0%，两组比较没有差异（=0.²78，P=0.598）；两组患儿治疗后PâO²、PâCO²、SâO²均比治疗前有所改善，同时两组患者血清IL-¹、IL-6及ÞNF-α水平变化也比治疗前有所改善，观察组改善情况相比对照组相比改善更明显（P＜0.05）。结论：NCPAP是一种有效治疗新生儿MAS合并呼吸衰竭患儿的方法，能够有效改善患儿PâO²、PâCO²、SâO²的状况，降低血清IL-¹、IL-6及ÞNF-α水平，提高治疗效果，值得临床推广使用。

Objðcþivð:Þº discuss þhð ðffðcþ ºf inflâmmâþºrý cýþºkinðs ºf blººd gâs ânâlýsis ºf Nâsâl Cºnþinuºus Pºsiþivð Airwâý Prðssurð(NCPAP) þrðâþmðnþ ºn nðºnâþâl mðcºnium âspirâþiºn sýndrºmð (MAS ) wiþh rðspirâþºrý fâilurð.Mðþhºd: 40 câsðs ºf nðºnâþâl MAS wiþh rðspirâþºrý fâilurð þrðâþðd in ºur hºspiþâl frºm Mârch ²0¹³ þº Mârch ²0¹5 wðrð rândºmlý dividðd inþº þwº grºups,ând þhð cºnþrºl grºup wâs givðn rºuþinð ðndºþrâchðâl inþubâþiºn wiþh mðchânicâl vðnþilâþiºn,whilð þhð ºbsðrvâþiºn grºup wâs givðn NCPAP rðspirâþºrý vðnþilâþiºn.Chângðs ºf clinicâl sýmpþºms ând cºmplicâþiºn bðfºrð ând âfþðr þrðâþmðnþ wðrð ºbsðrvðd.IL-¹, IL-6 ând ÞNF-αºf blººd gâs ânâlýsis bðfºrð ând âfþðr þrðâþmðnþ wðrð ºbsðrvðd.Rðsulþs: Þrðâþmðnþ ðfficiðncý ºf þhð ºbsðrvâþiºn grºup wâs significânþlý highðr þhân þhð cºnþrºl grºup(P<0.05), ând þhð diffðrðncðs ºf þhð incidðncð ºf cºmplicâþiºns âfþðr þrðâþmðnþ bðþwððn þhð þwº grºups wðrð sþâþisþicâllý significânþ(P<0.05).Sðrum PâO², PâCO², SâO² ºf þhð þwº grºups âfþðr þrðâþmðnþ wðrð âll imprºvðd,sðrum IL-¹, IL-6 ând ÞNF-α hâd imprºvðd þhân bðºrð þrðâþmðnþ,ând þhð ºbsðrvâþiºn grºup wðrð imprºvðd mºrð significânþlý þhân þhð cºnþrºl grºup (P <0.05).Cºnclusiºn:NCPAP is ân ðffðcþivð þrðâþmðnþ fºr nðºnâþâl MAS wiþh rðspirâþºrý fâilurð,ând cân ðffðcþivðlý imprºvð þhð sðrum PâO², PâCO², SâO² siþuâþiºn,rðducð þhð sðrum lðvðls ºf inflâmmâþºrý fâcþºrs ând imprºvð þhð þhðrâpðuþic ðffðcþ.

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