联合应用肺表面活性物质和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

Surfactant and protective lung mechanical ventilation strategy on meconium aspiration syndrome

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(MAS)的治疗效应。方法MAS患儿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例采用保护性肺通气治疗。观察两组患儿的临床转归,并监测24h内PaO2、氧合指数(OI)。结果治疗后,两组患儿肺的氧合功能均明显提高,但在时限和程度上B组均明显好于A组。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疗效,且并发症显著减少。

Objective To assess the efficacy of combined exogenous pulmonary surfactant and protective lung mechanical ventilation strateg）, on meconium aspration syndrome. Methods Thirty-five infants with MAS were randomly divided into two groups A and B,PS （200 mg/kg） was dropped into the tracheal tube at beginning with all infants ,group A included 18 patients who received mechanical ventilation , group B included 17 patients who received protective lung mechanical ventilation strategy ,the clinical results of two groups were observed, and PaO.,,oxygenation index were determined at different time points during 24 h of treatment. Results In these patients only two died （5.71）, comparison with our past similar patient indicated that the mortality and morbidity were remarkably declined ,the PaO,. of group B was higher than that of group A（P 〈 0.01 ）. The oxygenation index in groups B was significantly lower than that in group A （P 〈 0.01）. Conclusions The combined use of exogenous PS and protective lung mechanical ventilation exerts synergetic therapeutic effect on the MAS.