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目的观察猪肺磷脂注射液联合鼻塞式气道正压通气治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法选取2014年7月—2016年7月聊城市冠县人民医院收治的NRDS患儿80例,根据入院顺序分为对照组和观察组,每组40例。对照组患儿采用猪肺磷脂注射液联合持续气道正压通气治疗,观察组患儿采用猪肺磷脂注射液联合鼻塞式气道正压通气治疗。比较两组患儿治疗后1周临床疗效和治疗期间不良反应/并发症发生情况,入院时及治疗72 h后呼吸功能指标[包括第1秒用力呼气容积(FEV_1)、呼气峰流速(PEF)及第1秒用力呼气容积占预计值百分比(FEV_1%)],血清肿瘤坏死因子-α(TNF-α)、白介素10(IL-10)及铁蛋白(SF)水平。结果治疗后1周观察组患儿临床疗效优于对照组(P<0.05)。治疗前两组患儿FEV_1、PEF、FEV_1%比较,差异无统计学意义(P>0.05);治疗后观察组患儿FEV_1、PEF、FEV_1%高于对照组(P<0.05)。治疗前两组患儿血清TNF-α、IL-10、SF水平比较,差异无统计学意义(P>0.05);治疗后观察组患儿血清TNF-α、SF水平低于对照组,血清IL-10水平高于对照组(P<0.05)。观察组患儿治疗期间不良反应/并发症发生率低于对照组(P<0.05)。结论猪肺磷脂注射液联合鼻塞式气道正压通气治疗NRDS的临床疗效确切,可有效改善患儿呼吸功能并减轻炎性,降低血清TNF-α、SF水平,升高血清IL-10水平,且安全性较高。
Objective To observe the clinical efficacy of pulmonary phlebitis combined with nasal endoscopic positive airway pressure in the treatment of neonatal respiratory distress syndrome (NRDS). Methods From July 2014 to July 2016, 80 children with NRDS who were admitted to Guan County People’s Hospital of Liaocheng City were divided into control group and observation group according to admission sequence, 40 cases in each group. The control group of children with pulmonary phlebitis injection combined with continuous positive airway pressure treatment, observation group of children with pulmonary phlebitis combined with nasal positive airway pressure therapy. The clinical efficacy and the incidence of adverse reactions / complications during the first week after treatment were compared between the two groups. The indexes of respiratory function (including FEV 1, peak expiratory flow rate PEF), forced expiratory volume in 1 second (FEV 1%), serum levels of TNF-α, IL-10 and SF. Results One week after treatment, the clinical efficacy of the observation group was better than that of the control group (P <0.05). There was no significant difference in FEV_1, PEF and FEV_1% between the two groups before treatment (P> 0.05). After treatment, FEV_1, PEF and FEV_1% of children in observation group were higher than those in control group (P <0.05). The serum levels of TNF-α, IL-10 and SF in the two groups before treatment were not significantly different (P> 0.05). The levels of serum TNF-α and SF in the observation group were lower than those in the control group -10 levels higher than the control group (P <0.05). The incidence of adverse reactions / complication in observation group was lower than that in control group (P <0.05). Conclusion Porcine pulmonary phospholipid injection combined with nasal airway pressure positive airway pressure treatment of NRDS exact clinical efficacy, can effectively improve children’s respiratory function and reduce inflammation, reduce serum levels of TNF-α, SF, increased serum IL-10 levels, And high security.