肺表面活性物质在新生儿重症肺炎治疗中的应用价值

Application of pulmonary surfactant in the treatment of severe neonatal pneumonia

目的:评价肺表面活性物质(PS)治疗新生儿重症肺炎的有效性及安全性,监测肺表面活性蛋白B(SP-B)在新生儿重症肺炎治疗前后的变化。方法:将48例重症肺炎新生儿分为治疗组(23例)和常规组(25例)。两组患儿均给予机械通气治疗。治疗组同时给予PS治疗,气管内给药。结果:治疗组的氧合指数(OI)明显低于常规组,动脉/肺泡氧分压比值(a/APO2)明显高于常规组,差异有统计学意义(P<0.05)。治疗组氧暴露时间明显小于常规组,差异有统计学意义(P<0.05)。治疗组机械通气时间小于常规组,差异有统计学意义(P<0.05)。治疗组血清中及支气管肺泡灌洗液中SP-B的水平均显著高于常规组。两组患儿均治愈出院,无死亡病例。结论:PS治疗新生儿重症肺炎是有效的和安全的,可促进内源性肺表面活性物质的生成。

Objective： To evaluate the efficacy and safety of pulmonary surfactant（ PS） on severe neonatal pneumonia. Methods： 48 newborn patients were divided into two separate groups,i. e.,experimental group and conventional group. Both groups of patients were treated with mechanical ventilation. The experimental group additionally got intratracheal PS at the same time. Results： After treatment,the oxygenation index（ OI） of experimental group was significantly lower than that of the conventional group（ P〈0. 05）,and arterial / alveolar oxygen partial pressure ratio（ a / APO2） was significantly higher than that of the conventional group（ P〈0. 05）.Oxygen exposure of experimental group was significantly less than that of the conventional group（ P〈0. 05）.Duration of ventilation in experimental group was significantly shorter than that of the conventional mechanical（ P〈0. 05）. SP-B level in serum and bronchoalveolar lavage fluid of experimental group was significantly higher than that of the conventional group（ P〈0. 05）. Both groups of newborn patients were cured,no death occurred.Conclusion： PS treating neonatal severe pneumonia is safe and effective,and using exogenous pulmonary surfactant as a therapy for severe neonatal pneumonia can promote the formation of endogenous pulmonary surfactant.