肺表面活性物质不同给药方式治疗急性呼吸窘迫综合征的临床研究

目的：探讨肺表面活性物质不同给药方式治疗急性呼吸窘迫综合征的临床疗效。方法：选择我院2010年6月～2011年7月收治的各种原因导致急性呼吸窘迫综合征并进行机械通气治疗的患者69例，随机分为两组，对照组34例，观察组35例。分别采用气管插管滴入和雾化吸入的方法给予肺表面活性物质治疗，并观察记录两组患者治疗前后的动脉血气指标、呼吸力学指标、肺损伤评分、预后情况及不良反应发生情况。结果：经治疗两组患者血氧分压（PaO2）、血氧饱和度（SaO2）和氧合指数（PaO2／FiO2）明显升高，动脉血二氧化碳分压（PaCO2），肺泡一动脉血氧分压差（A—a）DO2明显降低；与治疗前比较，两组患者气道峰压（PPEAK）、气道阻力（RAW）明显降低，肺顺应性（CL）明显升高；两组患者治疗后肺损伤评分明显降低。治疗后1个月随访。观察组患者呼吸机使用时间及人住ICU时间低于对照组，存活率高于对照组。结论：雾化吸入给予PS能够在患者吸氧的同时迅速、有效地将PS送达肺部并发挥疗效，缓解患者症状。

Clinical research in different infusion modes of pulmonary surfactant therapy for respiratory distress syndrome

Objective ： To investigate the： different Infusion modes of pulmonary surfactant therapy for respiratory distress syndromcr Methods： Chose 69 cases from June 2010 to July 2011 were all causes ARDS and mechanical ventilation treatment were randomly divided into two groups, control group with 34 eases, observation group with 35 cases,used methods of tracheal intubation drip and spray inhalation pulmonary surfactant therapy, qbservated and recorded two groups of patients before and after treatment of arterial blood gas indicators, respiratory, mechanics, score, prognosis of pulmonary injury and adverse reac- tions occui＇： Results ：The two grbups of,patibhts and treatment PaO2, SaO2. PaO2/FiO2 significantiy inci-eased, PaCO2 significantly reduced; Compared with before treatment, two groups of patients PaO2 improved significazlfly and （A -a） DO2 significantly reduced, compared with before treatment, two groups of patients PPEAK, RAW iSignificantly reduced ,CL significantly increased, two groups of patients after treatment, the lung injury serre significantly reduced, treatment, one month after the follow - up record shows that. aerosolized group patients breathe machine use time and time significantly below the ICU endo- tracheal intub＇ation drip into the greups-gf patients, the survival rate was significantly higher than tracheal intubation drip into＇the group. Conclusion：The newly optimized oxygen - driven aerosol system can introduce exogenous pulmonary suffactant into the lungs and alleviate conditions.