Abstract：Objective: To observe the efficacy of combined treatment of pulmonary surfactant and non-invasive high-frequency oscillatory ventilation in neonatal respiratory distress syndrome (NRDS). Methods: 80 cases of children patients with NRDS admitted to our hospital from May 2017 to April 2018 were selected for the study and were randomly divided into observation group and control group according to the random number table method, with 40 cases in each group. Control group was given conventional ventilation combined with pulmonary surfactant, and observation group was treated with non-invasive high-frequency oscillatory ventilation combined with pulmonary surfactant. The effective rate of treatment, general conditions and arterial blood gas indexes [arterial partial pressure of oxygen (PaO2), pH value, partial pressure of carbon dioxide (PaCO2), percentage of inhaled oxygen concentration (FiO2), oxygenation index (OI)] and the incidence rate of complications were recorded in the two groups. Results: The effective rate of treatment in observation group was higher than that in the control group (90.00% vs 70.00%) (P<0.05). The operative time, symptom relief time and hospital stay in observation group were shorter than those in control group (P<0.05), and there was no significant difference in intermittent forced ventilation time and survival rate between the two groups (P>0.05). The PaO2 and pH value in observation group at 24h of embarkation were higher than those in control group while the PaCO2, FiO2 and OI were lower than those in control group (P<0.05). There were no significant differences in the incidence rate of complications (pneumothorax, pulmonary hemorrhage, bronchopulmonary dysplasia, pneumonia) between the two groups (P>0.05). Conclusions: The combined treatment of pulmonary surfactant and non-invasive high frequency oscillatory ventilation in children with NRDS can significantly improve the curative effect, shorten the time of going on the machine and hospitalization, and effectively improve the arterial blood gas index without significantly increasing complications, which is worthy of clinical application
[1] Sweet DG,Carnielli V,Greisen G,et al.European consensus guidelines on the management of respiratory distress syndrome-2016 update[J].Neonatology,2016,111(2):107~125. [2] 吴杰斌,周彬,翟敬芳,等.不同无创通气模式联合肺表面活性物质在新生儿呼吸窘迫综合征初始呼吸支持的临床应用[J].中华临床医师杂志(电子版),2017,11(3):383~387. [3] 朱兴旺,闫军,冉琴,等.无创高频振荡通气治疗新生儿呼吸窘迫综合征的初步研究[J].中华新生儿科杂志(中英文),2017,32(4):291~294. [4] David G.Sweet,Virgilio Carnielli,Gorm Greisen,等.欧洲新生儿呼吸窘迫综合征防治共识指南:2016版[J].中华儿科杂志,2017,55(3):169~176. [5] Smolarova S,Kocvarova T,Matasova K,et al.Impact of updated europe an consensus guidelines on the management of neonatal respiratory distress syndrome on clinical outcome of preterm infants[J].Adv Exp Med Biol,2015,835(1):61~66. [6] 雷克竞,谭静,唐国红,等.高频振荡通气治疗新生儿呼吸窘迫综合征的疗效观察[J].西部医学,2016,28(5):705~708. [7] 郑肖瑾.高频震荡通气联合肺泡表面活性物质治疗新生儿呼吸窘迫综合征的临床研究[J].检验医学与临床,2018,15(4):549~551. [8] 黄方,陈霞,饶绘,等.高频振荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征[J].川北医学院学报,2017,32(3):332~335. [9] 陈均,彭锡兰,吴雄基,等.高频震荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的临床研究[J].河北医学,2015,21(7):1125~1128. [10] Taki K,Huang DT.High-frequency oscillation in early adult respiratory distress syndrome[J].Crit Care,2014,18(3):310~313. [11] 韩娟.肺表面活性物质联合高频震荡通气对新生儿呼吸窘迫综合征的临床疗效[J].国际呼吸杂志,2016,36(18):1399~1402.
2019, Vol. 25 
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