改良法注入肺表面活性物质治疗新生儿肺内/肺外源性急性肺损伤的临床效果评价

Clinical Evaluation of Modified Pulmonary Surfactant Injection in the Treatment of Neonatal Pulmonary/Extrapulmonary Acute Lung Injury

目的:评价改良法注入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:从笔者所在医院新生儿科2015年1月-2018年1月的住院患儿中选择被确诊为新生儿肺内/肺外源性急性肺损伤的患儿作为研究对象,一共80例,根据肺内/肺外源性进行分组,各40例,两组均接受常规治疗,采用肺表面活性物质PS进行替代治疗,药物为注射用牛肺表面活性剂(珂立苏)70mg/kg。当患儿出现肺出血,立即气管插管和进行机械通气治疗。观察和比较两组治疗前和治疗后动脉血气变化,并且观察患儿治疗的不良反应发生率。结果:与治疗前对比,治疗60min患儿的PaO2明显上升,PaCO2明显下降,pH有明显改善,治疗前和治疗60min的数据比较差异有统计学意义(P<0.05)。与对照组对比,观察组治疗60min的PaO2明显更高,PaCO2明显更低,pH改善更加明显,组间数据比较差异有统计学意义(P<0.05)。所有患儿均痊愈出院,没有发生严重不良反应。结论:改良法注入肺表面活性物质治疗新生儿肺内/肺外源性急性肺损伤具有良好的效果及安全性,但是更适用于肺外源性急性肺损伤,值得广泛应用及推广。

Objective:To evaluate the effect of modified pulmonary surfactant on the treatment of neonatal pulmonary/pulmonary acute lung injury. Method:A total of 80 children with neonatal pulmonary/pulmonary exogenous acute lung injury were selected from the hospitalized children of the neonatology department of the hospital from January 2015 to January 2018.Intrapulmonary/pulmonary exogenous grouping,40 cases in each group,both groups received routine treatment,using pulmonary surfactant PS for replacement therapy,the drug pulmonary surfactant PS as an alternative therapy.The drug was Calisux 70 mg/kg.When the patient developed pulmonary hemorrhage,he was immediately intubated and mechanically ventilated.The changes of arterial blood gas before and after treatment were observed and compared between the two groups,and the incidence of adverse reactions in the treatment was observed.Result:Compared with before treatment,PaO2 increased significantly,PaCO2 decreased significantly,pH improved significantly,and the differenced between pretreatment and 60 min were statistically significant(P<0.05).Compared with the control group,PaO2 was significantly higher in the observation group for 60 min,PaCO2 was significantly lower,and pH improvement was more obvious.The differences between the groups were statistically significant(P<0.05).All patients were discharged from hospital and no serious adverse reactions occurred.Conclusion:The modified method of injecting pulmonary surfactant has good effect and safety in the treatment of neonatal lung/exogenous acute lung injury,but it is more suitable for exogenous acute lung injury.It is worthy of widespread application and promotion.