呼吸机联合肺表面活性物质治疗新生儿重症胎粪吸入综合征效果分析

Effect of ventilator combined with pulmonary surfactant on severe meconium aspiration syndrome in newborns

目的探讨呼吸机联合肺表面活性物质治疗新生儿重症胎粪吸入综合征的效果。方法选择山西大医院2017年1月至2018年8月诊治的新生儿胎粪吸入综合征患儿82例,随机分为观察组42例与对照组40例。两组患儿均采用呼吸机治疗,观察组患儿则在该基础上联合应用肺表面活性物质治疗。结果观察组新生儿的各项呼吸机相关参数指标及上机时间指标均较对照组更优(P<0.05)。两组新生儿治疗前氧合指数(OI)和动脉/肺泡氧分压(a/APO2)比较差异未见统计学意义(P>0.05)。治疗后观察组新生儿的OI、a/APO2改善效果均优于对照组(P<0.05)。观察组新生儿的住院时间为(30.26±12.47)d,对照组为(55.48±26.42)d,差异有统计学意义(P<0.05)。观察组新生儿的并发症发生率以及病死率均低于对照组(P<0.05)。结论采取呼吸机和肺表面物质联合治疗新生儿重症胎粪吸入综合征有助于提高治疗效果,降低新生儿并发症率和死亡率,改善新生儿预后。

Objective To investigate the clinical effects of combined use of ventilators and pulmonary surfactants on neonatal severe meconium aspiration syndrome. Methods Eighty-two children with neonatal meconium aspiration syndrome diagnosed in Shanxi Dayi Hospital from January 2017 to August 2018 were randomly divided into observation group(n=42) and control group(n=40). Both groups were treated by ventilator, and the children in the observation group were treated with pulmonary surfactant additionally. Results The ventilator-related parameters and the ventialtion duration of the neonates in the observation group were significantly better than those in the control group (P<0.05). There was no significant difference in oxygenation index (OI) or arterial alveolar partial pressure of oxygen (a/APO2) between the two groups before neonatal treatment (P>0.05). The improvement of OI and a/APO2 in the observation group was better than that in the control group (P<0.05). The hospitalization time of the newborns in the observation group was (30.26±12.47) d, shorter than the (55.48±26.42)d of the control group, and the difference was significant(P<0.05). The complication rate and mortality of the newborns in the observation group were significantly lower than those in the control group (P<0.05). Conclusions The combination of respirator and pulmonary surfactant in the treatment of neonatal severe meconium aspiration syndrome can improve the therapeutic effect, reduce the complication rate and mortality of neonates, and improve the prognosis of neonates.