婴幼儿室间隔缺损围术期的肺保护策略

Analysis about strategies on lung protection of ventricular septal defect infants during perioperation

目的 探讨婴幼儿室间隔缺损围术期安全、有效的临床肺保护策略.方法 实验分4组,空白对照组、氨溴索组、甲泼尼龙组和乌司他丁组,通过对每组患儿术后呼吸功能指标和炎症反应指标比较,探讨婴幼儿室间隔缺损修补术后安全、有效的肺保护策略.结果 室间隔缺损修补术后,氨溴索组、甲泼尼龙组和乌司他丁组呼吸功能相关指标：入ICU时Ppeak、氧合指数、气道阻力和术后机械通气时间总体差异均有统计学意义（P＜0.05）;白细胞、C反应蛋白和降钙素原术后第1天总体差异无统计学意义（P＞0.05）,第3天总体差异有统计学意义（P＜0.05）.结论 氨溴索、甲泼尼龙和乌司他丁均为有效的肺保护药物.综合考虑临床疗效及药物副作用,氨溴索为相对安全、有效的肺保护药物.

Objective Approach to safe and effective lung protection strategies on ventricular septal defect infants during perioperation.Methods There were 4 groups as blank control group,ambroxol group,methylprednisolone group and ulinastatin group.We tried to find a safe and effective stratege on lung protection by comparing each other on the respiratory function indexes and inflammation biomarkers.Results Postoperation of VSD repair,respiratory function indexes such as Ppeak,oxygenation index inspiratory resistance and mechanical ventilation time were significantly different （P ＜ 0.05） among the 4 groups.The inflammation biomarkers such as WBC,CRP and PCT had no differences the first day（P ＞0.05）,and were statistically significant the third day （P ＜ 0.05）.Conclusions Ambroxol,methylprednisolone and ulinastatin all are effective drugs for lung protection.Considering about the clinical curative effect and side effects,ambroxol is more safe and effective relatively.