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目的:探讨经鼻持续气道正压通气(NCPAP)对胎粪吸入综合征(MAS)合并呼吸衰竭新生儿血清炎症因子的影响。方法:将我院收治的40例新生儿MAS合并呼吸衰竭患儿随机分为两组各20例,对照组予常规有创经气管内插管机械通气,观察组予NCPAP呼吸通气。观察患儿治疗前后临床症状变化、并发症发生情况,以及治疗前后PaO_2、PaCO_2、SaO_2、血清白细胞介素(IL)-1、IL-6及肿瘤坏死因子-α(TNF-α)水平变化情况。结果:观察组患儿治疗有效率明显高于对照组(P=0.048),并发症发生率明显低于对照组(P=0.038);治疗后两组患儿PaO_2、SaO_2值均明显升高,PaCO_2值明显减低,观察组患儿PaO_2、SaO_2值明显高于对照组,PaCO_2值明显低于对照组(P<0.05);两组治疗后PaO_2、PaCO_2、SaO_2值均较治疗前有所改善,血清IL-1、IL-6及TNF-α水平均较治疗前明显下降,观察组下降水平比对照组更明显(P<0.05)。结论:NCPAP是一种有效治疗新生儿MAS合并呼吸衰竭的方法,能够有效改善患儿PaO_2、PaCO_2、SaO_2的状况,降低血清IL-1、IL-6及TNF-α水平,提高治疗效果,值得临床推广使用。
Objective: To investigate the effect of nasal continuous positive airway pressure (NCPAP) on serum inflammatory cytokines in neonates with respiratory failure due to meconium aspiration syndrome (MAS). Methods: Forty neonates with MAS complicated with respiratory failure admitted to our hospital were randomly divided into two groups of 20 patients. The control group was given routine mechanical ventilation through endotracheal intubation and the control group received NCPAP ventilation. The changes of clinical symptoms and complications before and after treatment were observed, and the changes of PaO_2, PaCO_2, SaO_2, serum IL-1, IL-6 and TNF-α levels before and after treatment . Results: The effective rate of treatment group was significantly higher than that of control group (P = 0.048), and the complication rate was significantly lower than that of control group (P = 0.038). After treatment, the PaO_2 and SaO_2 values in both groups were significantly increased, The values of PaCO_2 and PaCO_2 in the observation group were significantly higher than those in the control group (P <0.05), and the values of PaCO_2, PaCO_2 and SaO_2 in the observation group were significantly lower than those in the control group (P <0.05) The serum levels of IL-1, IL-6 and TNF-α were significantly lower than those before treatment, and the decrease in the observation group was more significant than that in the control group (P <0.05). Conclusion: NCPAP is an effective treatment of neonatal MAS complicated with respiratory failure, which can effectively improve the condition of PaO_2, PaCO_2 and SaO_2 in children, reduce the level of serum IL-1, IL-6 and TNF-α and improve the therapeutic effect, which is worth Clinical use.