肺表面活性物质稀释剂肺泡灌洗治疗新生儿胎粪吸入综合征的疗效及安全性

Efficacy and safety of bronchoalveolar lavage with diluent of pulmonary surfactant in neonates with meconium aspiration syndrome

目的探讨肺表面活性物质(PS)稀释剂肺泡灌洗治疗新生儿胎粪吸入综合征(MAS)的疗效及安全性。方法 MAS患儿58例分为肺泡灌洗组(A组,25例)和常规治疗组(B组,33例)。ELISA法检测治疗前和治疗后24、72h两组支气管肺泡灌洗液(BALF)中肺表面活性蛋白(SP)-A、SP-D及血管内皮生长因子(VEGF)的含量,记录相关呼吸指标。结果治疗后,A组BALF中SP-A、SP-D含量高于B组(P<0.05);而VEFG含量低于B组(P<0.05)。A组机械通气时间和氧暴露时间为(79.0±19.6)h和(105.6±28.8)h,均少于B组的(111.9±26.1)h和(139.2±22.5)h(P<0.05)。结论 PS稀释剂肺泡灌洗治疗MAS可抑制肺部炎症,减轻肺损伤,改善预后。

Objective To investigate the efficacy and safety of bronchial veolar lavage（BVL） with diluent of pulmonary surfactant（PS） in neonates with meconium aspiration syndrome（MAS）. Methods A total of 58 neonates with MAS was assigned into groups of A（BVL with PS diluent, 25 cases） and B（conventional treatment,33 cases）. The contents of surfactant protein A（SP-A）,SP-D and vascular endothelial growth factor （VEGF） in BAL fluid were detected by ELISA before treatment, at 24 h and 72 h after treatment. Breathing-associated indicators were recorded. Results The contents of SP-A and SP-D were higher and VEGF content was lower in group A than those in group B after treatment（P〈0. 05）. The times of mechanical and oxygen exposure were less in group A than those in group B[-（79.0±19.6） h and （105.6±28.8） h vs. （111.9 ±26.1） h and （139.2±22.5） hi （P〈0.05）. Conclusion Bronchoalveolar lavage with PS diluent in the treatment of MAS can suppress lung inflammation, reduce lung injury and improve prognosis.