联合应用肺表面活性物质和保护性通气策略治疗婴儿急性呼吸窘迫综合征

Infantile acute respiratory distress syndrome treated with combined application of pulmonary surfactant and lung protective ventilation strategy

目的:探讨联合应用肺表面活性物质和保护性通气策略治疗小儿急性呼吸窘迫综合征(ARDS)的效果。方法:将14例ARDS患儿随机分为A、B两组:A组7例,采用保护性通气治疗;B组7例,采用肺保护性通气策略基础上经气管插管应用外源性肺表面活性物质(PS)治疗。观察两组患儿的临床转归,并监测PaO2、氧合指数(O I)。结果:与以往同类疾病的治疗结果相比,患儿的死亡率和并发症显著降低;在治疗后各个时点,B组PaO2、氧合指数(O I)均高于A组(P<0.05)。结论:外源性PS与肺保护性通气具有协同作用,两者联合应用可明显提高ARDS患儿抢救成功率。

Objective：To explore the clinical efficacy of combined application of pulmonary surfactant and lung protective ventilation strategy in treatment of acute respiratory distress syndrome（ARDS） in children.Methods：14 children with ARDS were divided into group A and group B randomly： 7 children in group A were treated with lung protective ventilation strategy,7 children in group B were treated with exogenous pulmonary surfactant by endotracheal intubation based on lung protective ventilation strategy;the clinical prognosis of children in the two groups were observed,PaO2 and oxygenation index were monitored.Results：Mortality and incidence of complications of the children decreased significantly compared with past similar patients;PaO2 and oxygenation index of group B were significantly higher than those of group A at different time points after treatment（P〈0.05）.Conclusion：Combined application of exogenous pulmonary surfactant and lung protective ventilation strategy exerts synergetic effect in treatment of ARDS,which may improve the success rate of rescue for children with ARDS.