肺表面活性物质治疗新生儿肺内/肺外源性急性肺损伤研究

Pulmonary Surfactant in the Treatment of Neonatal Intrapulmonary/Extrapulmonary Acute Lung Injury

目的:探究肺表面活性物质治疗新生儿肺内/肺外源性急性肺损伤的效果。方法:选取2017年1月-2018年4月在本院接受治疗的新生儿肺内/肺外源性急性肺损伤患儿56例作为研究对象,根据不同的病因将其分为内源性组(n=28)和外源性组(n=28)。所有患儿均采用肺表面活性物质治疗,比较两组治疗前后的肺顺应性和氧合指数以及各项治疗指标。结果:治疗前两组肺顺应性数值及氧合指数比较,差异均无统计学意义(P>0.05);治疗2、24、48 h后以及拔管前,外源性组肺顺应性数值及氧合指数均明显高于内源性组,差异均有统计学意义(P<0.05)。外源性组机械通气、氧疗和住院时间均明显短于内源性组,并发症和病死发生情况均明显低于内源性组,差异均有统计学意义(P<0.05)。结论:肺表面活性物质治疗肺外源性急性肺损伤,效果要好于肺内源性急性肺损伤,值得临床推广。

Objective：To explore the effect of pulmonary surfactant in the treatment of neonatal intrapulmonary/extrapulmonary acute lung injury.Method：A total of 56 neonates with intrapulmonary/extrapulmonary acute lung injury treated from January 2017 to April 2018 were selected as the study objects.According to different etiologies,they were divided into endogenous group （n=28） and exogenous group （n=28）.All the children were treated with pulmonary surfactant,and the pulmonary compliance,oxygenation index and treatment indexes before and after treatment between the two groups were compared.Result：There were no significant differences in pulmonary compliance and oxygenation index between the two groups before treatment （P〉0.05）;pulmonary compliance and oxygenation indexes after treatment 2,24,48 hours and before extubation in the exogenous group were significantly higher than those in the endogenous group,the differences were statistically significant（P〈0.05）.The duration of mechanical ventilation,oxygen therapy and hospitalization in the exogenous group were significantly shorter than those in the endogenous group,and the incidence of complications and mortality were significantly lower than those in the endogenous group,the differences were statistically significant （P〈0.05）.Conclusion：The effect of pulmonary surfactant in the treatment of extrapulmonary acute lung injury is better than intrapulmonary acute lung injury.It is worthy of clinical promotion.