NCPAP下联合氨溴索气管内灌洗及固尔苏治疗重症胎粪吸入综合征的临床观察

Clinical observation of joint lavage ambroxol trachea and curosurf under CPAP treatment of severe meconium aspiration syndrome

目的观察NCPAP(经鼻气道正压通气)下联合氨溴索气管内灌洗及肺表面活性剂(PS)治疗重症胎粪吸入综合征(MAS)的临床疗效。方法选取重症MAS患儿106例,随机分为观察组及对照组各53例,在常规治疗基础上均给予氨溴索气管内灌洗联合肺表面活性剂(固尔苏)治疗,其中对照组给予头罩吸氧,观察组给予NCPAP吸氧,观察分析两组患儿治疗前后肺氧合功能、血气分析、氧疗时间、呼吸困难改善时间、肺部啰音消失时间、住院时间等临床疗效及并发症、应用有创呼吸机及死亡发生率等情况。结果治疗后两组患儿氧分压、氧饱和度均提高,且观察组患儿呼吸困难改善时间、肺部啰音消失时间、氧疗时间、住院时间均低于对照组,应用有创呼吸机治疗、并发症发生率及死亡率观察组均少于对照组,且两组差异具有统计学意义(P<0.05)。结论 NCPAP下联合氨溴索气管内灌洗及固尔苏治疗重症MAS,可缩短氧疗时间、住院时间及减少并发症、死亡病例发生及有创呼吸机的应用,值得临床推广。

Objective To observe the NCPAP（ nasal positive airway pressure） and pulmonary lavage clinical efficacy of surfactant（ PS） treatment of severe meconium aspiration syndrome（ MAS） within ambroxol trachea joint. Methods 106 cases of children with severe MAS,were randomly divided into two groups and the control group,53 patients in the conventional treatment were given on the basis of inside Ambroxol trachea joint lavage lung surfactant（ Curosurf） treatment,in which the control group give oxygen hood,observation group NCPAP oxygen,to observe and analyze the clinical efficacy of two groups of patients before and after treatment of pulmonary oxygenation,blood gas analysis,oxygen therapy,dyspnea improve time,pulmonary rales disappeared time,hospital stay and complications, the invasive ventilator and the incidence of death and so on.Results After treatment,children with oxygen partial pressure,oxygen saturation were increased,but the observation group of patients time to improve dyspnea,pulmonary rales disappeared time,oxygen therapy,hospital stays were lower than the control group, it was necessary to give invasive ventilator treatment,complications of cases and deaths in the observation group were less than the control group,and the difference was statistically significant（ P〈0. 05）. Conclusions NCPAP under the joint ambroxol trachea lavage and curosurf treatment of severe MAS,can shorten the duration of oxygen therapy,hospital stay and reduce complications and deaths occur and the invasive ventilator application,worthy of promotion.