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目的探讨肺表面活性物质(PS)治疗重症胎粪吸入综合征(MAS)的临床疗效。方法将83例重症MAS病例随机分成两组,41例作治疗组,在机械通气及常规治疗的同时应用PS150~240mg/kg治疗;42例患儿作对照组,给予机械通气及常规治疗,观察两组患儿的氧合功能、病程及预后。结果治疗后的不同时期,治疗组患儿的氧合指数(OI)低于对照组(1ht=2.521,12ht=3.423,24ht=3.372,36h,t=3.823,P<0.05);动脉/肺泡氧分压比值(a/APO2)高于对照组(1ht=2.47,P<0.05,12ht=3.724,P<0.05,24ht=3.923,P<0.01,36ht=2.783,P<0.05);治疗组呼吸机参数能早下调,机械通气时间、住院时间、并发气胸和呼吸机相关性肺炎(VAP)均显著少于对照组(t=5.15,9.52,χ2=8.38,11.7,P<0.05)。结论PS能有效改善MAS患儿的肺氧合功能,缩短机械通气时间及住院时间,减少气胸及VAP的并发症,提高存活率。
Objective To investigate the clinical efficacy of pulmonary surfactant (PS) in the treatment of severe meconium aspiration syndrome (MAS). Methods 83 cases of severe MAS were randomly divided into two groups and 41 cases were treated with PS150 ~ 240mg / kg while mechanical ventilation and routine treatment were given. Forty-two children served as control group, which were given mechanical ventilation and routine treatment. Oxygenation function, course of disease and prognosis in two groups of children. Results Oxygenation index (OI) of the treatment group was lower than that of the control group (1ht = 2.521,12ht = 3.423,24ht = 3.372,36h, t = 3.823, P <0.05) (A / APO2) was higher than the control group (1ht = 2.47, P <0.05,12ht = 3.724, P <0.05,24ht = 3.923, P <0.01,36ht = 2.783, P < Parameters can be reduced early, mechanical ventilation time, hospital stay, pneumothorax and ventilator associated pneumonia (VAP) were significantly less than the control group (t = 5.15,9.52, χ2 = 8.38,11.7, P <0.05). Conclusion PS can effectively improve pulmonary oxygenation in children with MAS, shorten the duration of mechanical ventilation and hospital stay, reduce the complications of pneumothorax and VAP, and improve the survival rate.