肺表面活性物质稀释液气管内灌洗给药治疗重症MAS的效果评价

Efficacy evaluation of the effect of pulmonary surfactant diluent in the treatment of severe MAS by intratracheal lavage

目的探讨肺表面活性物质稀释液气管内灌洗给药治疗重症新生儿胎粪吸入综合征的临床效果。方法将2014年2月~2017年6月在我院接受治疗的60例重症MAS患者按照随机数字法平均分为两组,30例予以肺表面活性物质原液气管内注入治疗(对照组),30例予以肺表面活性物质稀释液气管内灌洗治疗(研究组)。比较两组患者临床疗效、有创机械通气时间、OI指数和动脉/肺泡氧分压水平及并发症发生情况。结果研究组患者治愈率(96.67%)显著高于对照组(83.33%)(P<0.05)。研究组有创机械通气时间显著短于对照组(P<0.05)。干预后研究组OI指数显著低于对照组,研究组动脉/肺泡氧分压比值显著高于对照组(P<0.05)。研究组患者并发症发生率(6.67%)显著低于对照组(26.67%)(P<0.05)。结论在重症MAS患者治疗中选择肺表面活性物质稀释液气管内灌洗给药治疗可显著改善患者肺部通气功能,提高患者治愈率,降低并发症发生率,安全有效。

Objective To investigate the clinical effect of pulmonary surfactant dilution lavage in the treatment of severe neonatal meconium aspiration syndrome （MAS）. Methods 60 patients with severe MAS were randomly divided into 2 groups according to the random number method from February 2014 to June 2017 in our hospital. 30 cases were treated with intratracheal injection of pulmonary surfactant solution （control group）, and 30 cases were treated with pulmonary surfactant dilution lavage fluid （Study Group）. The clinical efficacy, invasive mechanical ventilation time, OI index, arterial / alveolar oxygen partial pressure and complications were compared between the two groups. Results The cure rate of patients in the study group （96.67%） was significantly higher than that of the control group （83.33%） （P 〈 0.05）. The invasive mechanical ventilation time of the study group was significantly shorter than that of the control group （P 〈 0.05）. The OI index in the study group was significantly lower than that of the control group after intervention.The ratio of arterial / alveolar oxygen pressure in the study group was significantly higher than that in the control group （P 〈 0.05）. The incidence of complications in the study group （6.67%） was significantly lower than that of the control group （26.67%） （P 〈 0.05）. Conclusion Pulmonary surfactant diluent intratracheal lavage for severe MAS patients can significantly improve the pulmonary ventilation function, improve the cure rate and reduce the incidence of complications, which is safe and effective.