肺表面活性物质治疗新生儿重症胎粪吸入综合征的临床分析

Clinical analysis of pulmonary surfactant therapy in neonatal severe meconium aspiration syndrome

目的探讨肺表面活性物质(PS)治疗新生儿重症胎粪吸入综合征的临床效果。方法选择我院2014年1月至2016年6月收治的76例新生儿重症胎粪吸入综合征患儿作为研究对象,随机分为对照组(38例)和观察组(38例)。在常规对症治疗基础上,对照组患儿常规使用鼻塞式持续正压通气(NCPAP)治疗,观察组在对照组的基础上增加肺表面活性物质治疗,比较两组患者治疗前后不同时间段血气分析指标变化,并观察患儿NCPAP治疗时间和病死率。结果治疗2、12、24、48 h,观察组患儿PO_2水平均高于对照组,PCO_2水平低于对照组,差异均有统计学意义(P<0.05)。观察组患儿并发症发生率(5.26%)显著低于对照组(21.05%),观察组NCPAP治疗时间显著短于对照组,组间差异均有统计学意义(P<0.05)。两组患儿均在本院治愈或好转后离院,无死亡病例。结论新生儿重症胎粪吸入综合征采用PS治疗可显著提升患儿肺氧合功能,降低术后并发症风险,减少正压通气时间。

Objective To investigate the clinical effect of pulmonary surfactant （PS） in neonates with meconium aspiration syndrome. Methods Seventy-six cases of neonatals with severe meconium aspiration syndrome in our hospital from January 2014 to June 2016 were selected as the research objects, and were randomly divided into control group （38 eases） and observation group （38 eases）. On the basis of conventional symptomatic treatment, the control group was treated with conventional use of nasal continuous positive airway pressure （NCPAP） treatment, the observation group added pulmonary surfaetant on the basis of the control group. The blood gas analysis indexes at different periods before and after the treatment were compared, and the NCPAP treatment time and mortality rate were compared between the two groups. Results After the treatment for 2, 12, 24, 48 hours, the levels of PO2 were significantly all higher than that in the control group, and PCO2 in the observation group were significantly all lower than that in the control group （P〈0.05）. The incidence rate of complications in the observation group （5.26%） was significantly lower than that in the control group （21.05%）（P〈 0.05）, the NCPAP treatment time of the observation group was significantly shorter than that of the control group （P〈0.05）. Both groups healed or improved, without any death. Conclusion PS treatment applied in neonatal meconium aspiration syndrome can significantly improve oxygenation function of lung, reduce the risk of postoperative complications and positive pressure ventilation time.