应用保护性机械通气策略治疗新生儿胎粪吸入综合征临床研究

目的 探讨联合应用外源性肺表面活性物质（PS）和保护性肺通气策略对新生儿胎粪吸入综合征的治疗效果。方法 新生儿胎粪吸入综合征35例经气管插管应用外源性PS（200mg／kg），随机分为A和B两组，A组18例采用常规机械通气治疗；B组17例保护性肺通气治疗。观察两组患儿的临床转归，并监测24h内PaO2、氧合指数（OI）。结果 与以往同类病例的治疗结果相比，本组患儿病死率（5.71％）显著降低，并发症显著减少。在治疗后24h内的各个时点OI显著低于A组（P〈0．05～0.01）。结论 外源性PS与保护性肺通气具有协同作用，二者联合应用可明显提高MAS的疗效．且并发症显著降低。

The Application of Protective Mechanical Ventilation on Meconium Aspiration Syndrome in Neonates

Objective To assess the efficacy of exogenous pulmonary surfactant(PS) combined with protective lung mechanical ventilation on meconium aspiration syndrome(MAS).Methods Thirty five infants with MAS received PS(200 mg/kg) via tracheal intubations were randomly divided into group A and B.All 18 infants in group accepted conventional mechanical ventilation;however,17 patients from group B were performed by protective lung mechanical ventilation.To observe the clinical manifestation and detect the changes of PaO_2 and oxygenation index(OI) within 24 h after treatment in patients. Results The mortality(5.71%) and complications in the patients of group B were less than that in group A.The OIs of group B were lower than those of group A during various time after treatment.(P<0.01).the oxygenation index in groups B was significantly lower than that in group A(P<0.01).Conclusions The combination of exogenous PS with protective lung mechanical ventilation exerts synergistic action on the MAS,could increase curative effect and decrease incidence of complications.