电子支气管镜在重症胎粪吸入综合征中的临床应用研究

目的：探讨电子支气管镜在足月新生儿重症胎粪吸入综合征（MAS）中的临床治疗价值，提高MAS的治疗成功率。方法：选取2012年1月-2013年4月入住新生儿重症监护病房（NICU）确诊为重症MAS的足月患儿65例，按随机数字表法分为观察组32例和对照组33例。两组患儿均给予机械通气及常规支持疗法，观察组同时给予电子支气管镜肺泡灌洗，比较观察两组患儿的肺氧合功能、呼吸机参数变化、机械通气时间、氧疗时间、住院时间、住院费用，以及并发症发生率。结果：观察组肺氧合功能改善快且明显，呼吸机参数及时下调，机械通气及氧疗时间缩短，气漏及ARDS等并发症发生率低，住院时间缩短，住院费用减少，与对照组比较差异均有统计学意义（P〈0.05）。结论：MAS应用电子支气管镜进行肺泡灌洗，能及时有效改善肺氧合功能，缩短机械通气及氧疗时间，减少气漏等并发症的发生，减少住院时间及住院费用，是安全有效的，可在临床中推广应用。

Clinical Application Study on Electronic Bronchoscope in Severe Meconium Aspiration Syndrome

Objective：To investigate the clinical value of electronic bronchoscopic in the treatment of mature newborns with meconium aspiration syndrome（MAS）in order to improve the success rate of treatment in MAS. Method：65 cases of mature newborns were diagnosed with severe MAS and admitted the neonatal intensive care unit（NICU）and were selected from January 2012 to April 2013,were divided into the observation group 32 cases and the control group 33 cases according to random number table method. The two groups were given mechanical ventilation and routine therapy,and patients in the observation group were given electronic bronchoscopic alveolar wash. Pulmonary oxygenation function,ventilator parameters,the duration of mechanical ventilation,the duration of oxygen therapy,hospitalization time,cost of hospitalization and incidence rate of complications in the two groups were observed and compared. Result：Pulmonary oxygenation function, ventilator parameters,the duration of mechanical ventilation,the duration of oxygen therapy,hospitalization time,cost of hospitalization and incidence rate of complications in the two groups were compared,and the differences were statistically significant（P〈0.05）. Conclusion：Electronic bronchoscopic alveolar wash in meconium aspiration syndrome（MAS）can effectively improve oxygenation function,shorten the duration of mechanical ventilation and oxygen therapy,reduce the gas leakage and other complications,reduce hospitalization cost and hospitalization time,is safe and effective,can be widely used in the clinical.