早期肺表面活性物质微创给药在早产儿肺透明膜病预防中的应用价值

Application value of early minimally invasive treatment of pulmonary surfactant in the prevention of premature infants with pulmonary membrane disease

目的探究早期肺表面活性物质(PS)微创给药在早产儿肺透明膜病预防中的临床疗效及应用价值。方法选取2015年2月至2016年1月出生的126例早产儿为研究对象。采用随机数字表法将其分为对照组和预防组各63例,给予对照组常规机械通气,预防组在对照组的基础上采用微创给药的方式应用PS,比较两组患儿肺透明膜病发生率及7d内病死率,治疗前、治疗后24h血气分析相关指标变化情况,机械通气时间、总吸氧时间、住院时间以及并发症发生情况。结果预防组肺透明膜病发生率及7d内病死率分别为11.11%和6.35%,显著低于对照组的53.97%和23.81%,差异有统计学意义(P<0.05);治疗后24h两组PaCO_2水平显著降低,PaO_2和pH水平显著升高,差异均有统计学意义(P<0.05),预防组治疗后与对照组比较,差异有统计学意义(P<0.05);预防组住院时间、吸氧时间、通气时间较对照组显著缩短,差异均有统计学意义(P<0.05),且并发症发生率较对照组显著降低,差异均有统计学意义(P<0.05)。结论早期PS微创给药可显著降低早产儿肺透明膜病的发生率及7d病死率,预防作用显著,具有临床价值。

Objective To discuss the clinical treatment effect and application value of early minimally invasive treatment of pulmonary surfactant （PS） in the prevention of premature infants with pulmonary membrane disease.Methods One hundred and twenty-six cases of premature infants born in our hospital from February 2015 to January 2016 were selected as the research subjects,who were divided into control group and prevention group with 63 cases in each group according to the random digital table method.The control group was given conventional mechanical ventilation,while the prevention group was given early minimally invasive treatment of PS based on the control group.The incidence rates of pulmonary membrane disease and death rates were compared between the two groups,as well as the changes of blood gas analysis related indexes before treatment and after 24 h of treatment,mechanical ventilation time,total oxygen inhalation time,hospital stay and incidence of complications.Results The incidence rate of pulmonary membrane disease and death rate in the prevention group were 11.11% and 6.35% respectively,which were significantly lower than those of 53.97% and 23.81% in the control group （P〈0.05）.The levels of PaCO2 in the two groups after 24 h of treatment were significantly reduced,while the levels of PaO2 and pH were significantly increased the control group were statistically significant （P〈0.05）.The differences of the indicators between the prevention group and the control group were statistically significant （P〈0.05）.The length of stay,oxygen inhalation time,ventilation time in the prevention group were significantly shorter than those in the control group （P〈0.05）,and the incidence rate of complications was significantly lower than that of the control group the control group were statistically significant （P〈0.05）.Conclusion Early minimally invasive treatment of PS could significantly reduce the incidence rate and death rate of pulmonary membrane disease in premature infants,which has clinical value.