肺表面活性物质两种气管内给药方式治疗重症胎粪吸入综合征临床对比研究

目的:探讨肺表面活性物质气管内注入与灌洗给药治疗重症新生儿胎粪吸入综合征(MAS)临床疗效及安全性。方法:选取我院儿科2013年3月至2014年3月收治的重症MAS患儿共140例,采用随机数字表法分为A组和B组各70例,A组给予肺表面活性物质原液气管内注入治疗,B组给予肺表面活性物质稀释液气管内灌洗治疗,比较两组患儿治愈率、病死率、有创机械通气时间、治疗前后氧合指数(OI)、动脉/肺泡氧分压比值和并发症发生率。结果:B组患儿治愈率高于A组,病死率低于A组(P均<0.05);B组患儿有创机械通气时间短于A组,差异有统计学意义(P<0.05);B组患儿治疗后OI和动脉/肺泡氧分压比值均高于治疗前和A组治疗后,差异均有统计学意义(P<0.05);B组患儿治疗后并发症发生率显著低于A组,差异有统计学意义(P<0.05)。结论:肺表面活性物质稀释液气管内灌洗给药治疗重症MAS可提高治疗效果,改善肺部通气功能,并有助于降低病死率和并发症发生率,其疗效和安全性均优于气管内注入给药。

Clinical Comparative Study of Two Kinds of Endotracheal Drug Application with Pulmonary Surfactant in the Treatment of Children with Severe Meconium Aspiration Syndrome

Objective: To investigate the clinical effects and safety of endotracheal injection and lavage with pulmonary surfactant in the treatment of children with severe meconium aspiration syndrome (MAS). Methods: 140 children with severe MAS were chosen in recent years in our hospital and randomly divided into both group including A group (70 cases) with endotracheal injection with pulmonary surfactant and B group (70 cases) with endotracheal lavage with pulmonary surfactant; and the cure rate, mortality rate, mechanical ventilation time, before and after treatment OI index and ratio of arterial/alveolar oxygen partial pressure and the incidence of complications of both groups were compared. Results: The cure rate, mortality rate of B group was significantly better than A group (P<0.05). The mechanical ventilation time of B group was significantly shorter than A group (P<0.05). The OI index and ratio of arterial/alveolar oxygen partial pressure after treatment of B group was significantly better than A group and before treatment (P<0.05). The incidence of complications of B group was significantly better than A group (P<0.05). Conclusion: Compared with endotracheal injection, endotracheal injection and lavage with porcine pulmonary surfactant in the treatment of children with severe MAS can efficiently higher cure effects, improve lung function and be helpful to reduce the risk of death and complication.