肺表面活性物质(固尔舒)治疗新生儿重症胎粪吸入综合征28例

28 case reports of surfactant therapy (Curosurt) in neonates with meconium aspiration syndrome

目的:观察外源性肺表面活性物质(PS)治疗重症胎粪吸入综合征(MAS)的疗效。方法:将28例重症MAS病例随机分成两组,13例作治疗组,在上呼吸机及常规治疗同时应用PS治疗;15例作对照组,予呼吸机及常规治疗,观察监测两组患儿的肺氧合功能及病程和预后。结果:治疗后治疗组患儿的氧合指数(OI)从21.5±4.6渐降至12.8±1.6,同比低于对照组,差异有显著性(P<0.05);动脉/肺泡氧分压比值(a/APO2)从0.10±0.04升至0.31±0.05,同比高于对照组,差异有显著性(P<0.05);治疗组机械通气时间、用氧时间和住院时间分别为(3.5±1.9)d、(7.1±2.8)d、(13.4±4.6)d,对照组为(4.8±2.2)d、(10.3±3.6)d、(16.5±5.2)d,治疗组显著少于对照组(P<0.05)。结论:PS治疗能有效地改善MAS患儿的肺氧合功能,可缩短应用机械通气及用氧的时间及病程。

Objective: To study the efficacy of pulmonary surfactant (PS) in the newborn infants with severe meconium aspiration syndrome(MAS). Methods: 28 infants with severe MAS were randomly divided into two groups. The treatment group (13 cases) were treated with PS, control group (15 cases) were treated in usually way. Results: The mean oxygenation index (OI) of the PS group decreased from 21.5±4.6 to 12.8±1.6,which was significantly lower compared with control group (P < 0.05); arterial/alveolar oxygen tension ratio (a/APO2) of the PS group increased form 0.10±0.04 to 0.31±0.05, which was significantly higher compared with control group (P < 0.05). The durations of mechanical, oxygen therapy, and admission were significantly short in the PS group than in control group. Conclusion: PS therapy may result in a rapid improvement in oxygenation, and reduce the duration of mechanical ventilation and hospitalization time of newborn infants with severe MAS.