高频震荡通气联合肺表面活性物质治疗重症胎粪吸入综合征的疗效

Effect of High Frequency Oscillatory Ventilation Combined with Pulmonary Surfactant on Severe Meconium Aspiration Syndrome

目的探讨高频震荡通气联合气管滴入肺表面活性物质(固尔苏)治疗重症胎粪吸入综合征(MAS)的疗效。方法将30例重症胎粪吸入综合征患儿按随机数字表法分为观察组和对照组,每组15例。对照组采用常频通气联合气管滴入肺表面活性物质治疗;观察组采用高频震荡通气联合气管滴入肺表面活性物质治疗。对2组患儿疗效,PaO2、PaO2/吸入氧浓度(FiO2)和氧合指数(OI)的变化,机械通气时间及住院时间进行比较。结果观察组机械通气时间及住院时间明显低于对照组(均P<0.05);随着治疗时间的增加,观察组的PaO2、PaO2/FiO2和OI均明显优于对照组(均P<0.05)。结论高频震荡通气联合早期应用肺表面活性物质,能减轻炎症反应,有利于重症胎粪吸入综合征患儿的治疗。

Objective To investigate the effect of high frequency oscillatory ventilation combined with tracheal instillation of pulmonary surfactant （Curosurf） on severe meconium aspiration syndrome （MAS）. Methods Thirty cases of severe MAS were randomly divided into two groups, with 15 cases in each group. The control group was given normal frequency ventilation combined with endotraeheal instillation of pulmonary surfactant. The observation group was given high frequency oscillatory ventilation combined with endotracheal instillation of pulmonary surfactant. Curative efficacy,PaO2, PaO2/inspired oxygen concentration（FiOz）,oxygenation index （OI）,duration of mechanical ventilation and length of hospital stay were compared between the two groups. Results Compared with control group, the duration of mechanical ventilation and length of hospital stay significantly decreased in observation group （P〈0.05）. With the increase in treatment time,PaO2,PaO2/FiO2 and OI in observation group were significantly better than those in control group （P〈0.05）. Conclusion High frequency oscillatory ventilation combined with early application of pulmonary surfactant reduces response and contributes to the treatment of severe MAS in children. inflammatory