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目的探讨BAL联合PS治疗重症MAS的临床疗效及对6 h乳酸清除率的影响。方法回顾性分析本科2012年8月-2014年8月住院胎粪吸入综合征,BAL联合PS治疗前30例对照组,BAL联合PS治疗后30例为观察组,观察其临床疗效及对6 h乳酸清除率影响。结果对照组显效14例,有效9例,无效7例,观察组显效19例,有效9例,无效2例,2组比较,差异有统计学意义(χ2=7.44,P<0.01);治疗前后血气分析比较,治疗前p H值、Pa CO2、Pa O2、Sa O2、Lac分别为(7.11±0.20)、(62.70±7.90)k Pa、(47.30±6.70)k Pa、(89.70±5.60)%、(5.27±0.74)mmol/L,治疗后6 h p H值、Pa CO2、Pa O2、Sa O2、Lac分别为(7.31±0.21)、(55.31±6.81)k Pa、(55.20±7.40)k Pa、(94.30±4.20)%、(3.94±0.89)mmol/L,差异有统计学意义(P<0.01);不同临床疗效6 h乳酸清除率比较,显效>有效>无效,差异有统计学意义(P<0.01);血清6 h乳酸清除率与MAS临床疗效呈正相关(r=0.76,P<0.01)。结论 BAL联合PS能显著提高MAS临床疗效,血清6 h乳酸清除率能对MAS疗效判断具有重要临床意义。
Objective To investigate the clinical efficacy of BAL combined with PS in the treatment of severe MAS and its effect on 6 h lactic acid clearance. Methods A retrospective analysis was conducted between August 2012 and August 2014 in our hospital for maternal meconium aspiration syndrome. In the control group, 30 cases of BAL combined with PS before treatment and 30 cases of BAL combined with PS were observed. The clinical efficacy and the response to 6 hours Effect of lactate clearance. Results In the control group, 14 cases were markedly effective, 9 cases were effective, 7 cases were ineffective, 19 cases were markedly effective, 9 cases were effective and 2 cases were ineffective. There was significant difference between the two groups (χ2 = 7.44, P <0.01) Blood gas analysis showed that p H, PaCO 2, Pa O 2, Sa O 2 and Lac were (7.11 ± 0.20), (62.70 ± 7.90) kPa, (47.30 ± 6.70) kPa and (89.70 ± 5.60)% , (5.27 ± 0.74) mmol / L respectively. After 6 h of treatment, values of PaCO2, PaO2, SaO2 and Lac were (7.31 ± 0.21), (55.31 ± 6.81) kPa and (55.20 ± 7.40) kPa , (94.30 ± 4.20)% and (3.94 ± 0.89) mmol / L, respectively (P <0.01). The lactic acid clearance rate of different clinical curative effect at 6 h was significantly higher than that of effective, P <0.01). The 6 h serum lactic acid clearance rate was positively correlated with the clinical efficacy of MAS (r = 0.76, P <0.01). Conclusions BAL combined with PS can significantly improve the clinical efficacy of MAS. The 6 h serum lactic acid clearance rate has an important clinical significance in judging the therapeutic effect of MAS.