肺表面活性物质联合肺保护通气策略治疗新生儿重型胎粪吸入综合征合并急性肺损伤的疗效观察被引量：18

Effect of pulmonary surfactant combined with lung protective ventilation strategy on treatment of neonatal severe meconium aspiration syndrome complicated with acute lung injury

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摘要目的探讨肺表面活性物质联合肺保护性通气策略治疗重症胎粪吸入综合征合并急性肺损伤新生儿的临床效果。方法选取50例重症胎粪吸入综合征合并急性肺损伤患儿,随机分成治疗组和对照组各25例。治疗组采取肺表面活性物质联合肺保护性通气策略,而对照组仅采取肺保护性通气策略治疗。比较通气前及通气2、12、24 h以及治疗后2组患儿的呼吸机相关指数、氧合指数、肺顺应性指标,同时比较2组患儿通气时间和住院时间。结果 (1)呼吸机相关参数比较,治疗组患儿吸入氧浓度24 h内显著下降,动脉血氧分压显著上升,平均气道分压也在24 h内迅速下降,2组比较有显著差异(P<0.05)。(2)肺氧合指数比较上,治疗组患儿显著低于对照组患儿,在肺顺应性比较上,治疗组患儿显著高于对照组患儿。(3)治疗组患儿的通气时间和住院时间短于对照组患儿。讨论肺表面活性物质联合肺保护性通气策略对于治疗新生儿重型胎粪吸入综合征合并急性肺损伤的临床疗效优于单纯采用肺保护性通气策略。 ObjectiveTo explore the clinical effect of pulmonary surfactant combined with lung protective ventilation strategy on treatment of neonatal severe meconium aspiration syndrome （MAS） complicated with acute lung injury. MethodsA total of 50 neonates with severe MAS complicated with acute lung injury were randomly divided into treatment group and control group, with 25 cases in each group. The treatment group were treated with pulmonary surfactant combined with lung protective ventilation strategy, while the control group were only treated with lung protective ventilation strategy. The ventilator associated indexes, oxygenation index, lung compliance indexes, ventilation time and length of hospital stay of the two groups were recorded. Results① The inhaled oxygen concentration of treatment group decreased significantly within 24 hours, arterial partial pressure of oxygen increased significantly, the mean airway pressure decreased rapidly within 24 hours, and there were significant differences at different time points （P〈0.05）. ② The oxygenation index of treatment group was lower than that of the control group. The lung compliance of treatment group was higher than that of the control group. ③ The ventilation time and hospital stay of the treatment group were shorter than that of the control group. ConclusionThe curative effect of pulmonary surfactant combined with lung protective ventilation strategy is better than lung protective ventilation strategy alone in the treatment of neonatal severe MAS with acute lung injury.

作者蒋惠芬赵勇王金秀

机构地区南京医科大学附属常州妇幼保健院新生儿科

出处《实用临床医药杂志》 CAS 2017年第21期22-24,共3页 Journal of Clinical Medicine in Practice

关键词肺表面活性物质保护性通气重型胎粪吸入综合征急性肺损伤 pulmonary surfactant protective ventilation severe meconium aspiration syndrome acute lung injury

分类号 R722.12 [医药卫生—儿科]

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