牛肺磷脂注射液联合持续气道正压治疗重症胎粪吸入综合征疗效的回顾性研究

Retrospective observation of bovine lung phospholipid injection combined nasal continuous positive airway pressure for treating severe meconium aspiration syndrome

目的探讨牛肺磷脂注射液联合鼻塞持续气道正压(NCPAP)治疗重症新生儿胎粪吸入综合征(MAS)的临床疗效。方法 2013年在我科收治的重症MAS病例中选取36例,根据是否使用牛肺磷脂注射液分为2组,对照组给予NCPAP治疗,治疗组采用牛肺磷脂注射液联合NCPAP治疗,动态观察使用牛肺磷脂注射液后4,12,24,48 h患儿的氧分压(Pa O2)和二氧化碳分压(Pa CO2)、吸入氧浓度(Fi O2)及呼吸末正压(PEEP)的情况,并统计NCPAP通气时间、氧疗时间、改行有创机械通气病例数。结果在治疗后各时间点,治疗组的血Pa O2、血p H值高于对照组,血Pa CO2﹑吸氧浓度和PEEP低于对照组,同时,治疗组的CPAP使用时间﹑氧疗时间﹑改行有创机械通气病例数低于对照组,差异有统计学意义(P<0.05)。结论牛肺磷脂注射液联合NCPAP治疗重症MAS效果显著。

Objective To investigate the clinical efects of bovine lung phospholipid injection（ Kelisu） combined nasal continuous positive airway pressure（ NCPAP） for treating severe meconium aspiration syndrome（ MAS）.Methods Thirty- six infants with MAS in our department were selected,and divided into two groups according to whether or not to use Kelisu.Control group were given NCPAP therapy,treatment group were treated with Kelisu combined NCPAP.After using Kelisu 4,12,24,48 h,blood PaCO2,blood Pa O2,blood pH,Fi O2 and PEEP were observed.We also observed the time of using NCPAP,the oxygen cure time,the number of cases of diverted mechanical ventilation.Results Compared with the control group,the blood Pa O2,blood pH after 4,12,24,48 h treatment of the treatment group were higher,the blood PaCO2,Fi O2 and PEEP were lower,and the time of using NCPAP,the oxygen cure time,the number of cases of diverted mechanical ventilation were less（ P〈0.05）.Conclusion Bovine lung phospholipid injection fcombined NCPAP for treating severe meconium aspiration syndrome has better efects and is worth clinical application.