机械通气对重症胎粪吸入综合征的干预效果——多中心回顾性分析

Intervention effect of mechanical ventilation therapy on severe meconium aspiration syndrome in newborn infants:A multi-center retrospective survey

通过对81例重症胎粪吸入综合征 (MAS)机械通气的过程及参数分析 ,以了解机械通气对重症MAS的干预效果。对上海新华医院等9家医院的81例重度MAS ,用SAS软件对与疗效有关的因素进行秩和和χ2检验进行分析。81例中死亡32例 (39.5 % ) ,胎龄、1分钟Apgar评分、气胸及FiO2、PIP、MAP与疗效有关 ;48小时PH、72小时PaCO2、PaO2 及12小时后的SpO2 可判断预后。结果表明呼吸机治疗重症MAS死亡率仍较高 (接近40 % ) ,提示需重新认识常频通气对重症MAS的治疗效果。

To explore the intervention effects of mechanical ventilation(MV)therapy on meconium aspiration syndrome(MAS) in newborn infants,the ventilator settings and the response to therapy were analyzed. Factors affecting the outcomes of 81 cases with severe MAS from 9 children′s hospitals were retrospectively analyzed with SAS software,and non_parametric rank sum test and chi_square test were applied. The results showed that 32/81 infants(39.5%) died. The prognosis of these infants was significantly affected by following factors including gestational age,Apgar′s score at 1 minute,pneumothorax and FiO2,PIP and MAP. Furthermore,48_hour PH,72_hour PaCO2,and over 12_hour PaO2 and SpO2 could be used to predict the clinical outcomes. It is suggested that the effects of conventional MV therapy should be reevaluated owing to a high mortality on the MV therapy in severe MAS infants.