肺表面活性物质对新生儿重症胎粪吸入综合征炎症反应及氧合功能的影响

Effect of pulmonary surfactant on inflammatory reaction and oxygenation in neonates with meconium aspiration syndrome

目的探讨肺表面活性物质对新生儿重症胎粪吸入综合征炎症反应及氧合功能的影响。方法选取2013年2月至2015年2月我院收治的新生儿重症胎粪吸入综合征患儿46例为研究对象,采用随机数字表达将其分为对照组和研究组,每组23例。对照组患儿给予常规治疗及呼吸机辅助治疗;研究组患儿在对照组治疗的基础上加用肺表面活性物质治疗,比较两组患儿血清IL-8、IL-10水平,两组患儿不同时刻氧合功能(OI值、a/APO2值)的变化情况。结果治疗前两组患儿血清IL-8、IL-10水平比较,差异无统计学意义(P>0.05);治疗后两组患儿IL-8水平均显著降低、IL-10水平均显著升高(P<0.05),研究组患儿IL-8、IL-10水平均优于对照组(P<0.05或0.01)。治疗前(0 h)两组患儿OI、a/APO2值比较差异无统计学意义(P>0.05);治疗后1 h、12 h、24 h两组患儿OI值降低、a/APO2值升高(P<0.05),研究组患儿OI值显著低于对照组,a/APO2值显著高于对照组(P<0.05)。研究组患儿并发症发生率低于对照组,但差异无统计学意义(P>0.05)。结论在常规治疗的基础上加用肺表面活性物质治疗新生儿重症胎粪吸入综合征,可以有效减弱炎症反应,改善肺氧合功能,降低并发症发生率,具有良好的应用前景。

Objective To discuss the effect of pulmonary surfactant on inflammatory reaction and oxygenation in neonates with meconium aspiration syndrome. Methods A total of 46 cases of neonates with meconium aspiration syndrome admitted to our hospital from February 2013 to February 2015 were selected and randomly divided into control group and study group,with 23 cases in each group. The control group were given routine treatment and ventilator assisted therapy,while the study group were given pulmonary surfactant on the basis of the control group. The levels of interleukin-8（IL-8）,interleukin-10（IL-10）,and oxygenation at different moments were compared between the two groups. Results That was no significant differences in the levels of serum IL-8,IL-10 was found between the two groups before treatment（P 〉 0. 05）,the levels of IL-8 decreased significantly while the IL-10 increased significantly in the two groups after treatment in contrast with those before treatment,and the level of IL-8 in the study group was significantly lower than that in the control group（P 〈 0. 05）,and the level of IL-10 was significantly higher than that in the control group（P 〈 0. 05 or 0. 01）. That was no significant differences of oxygen index（OI） and arterial / alveolar oxygen partial pressure ratio（a / APO2） values was found between the two groups before treatment（P 〉 0. 05）,the OI values decreased significantly while the a / APO2 values increased significantly in the two groups after 1,12,24 hour of treatment in contrast with those before treatment（P 〈 0. 05）,the OI values in the study group significantly lower than that in the control group,and the a / APO2 values in the study group signficantly higher than that in the control group（P 〈 0. 05）. The incidence rate of complications in the study group was lower than that in the control group,but the difference was not statistically significant（P 〈 0. 05）. Conclusions Pulmonary surfactant combined with routine treatment can effectively weaken the inflammatory reaction in neonates with meconium aspiration syndrome,improve oxygenation function and reduce the incidence of complications,which has a good application prospect.