气管内滴入牛肺表面活性物质辅助经鼻双相正压通气模式治疗胎粪吸入综合征的疗效

Efficacy of Intratracheal Instillation of Bovine Pulmonary Surfactant Assisted by Nasal Biphasic Positive Airway Pressure in the Treatment of Meconium Inhalation Syndrome

目的:探讨气管内滴入牛肺表面活性物质辅助经鼻双相正压通气(N-BiPAP)治疗胎粪吸入综合征的疗效。方法:选取2016年2月至2019年1月我院收治的98例胎粪吸入综合征患儿,采用简单随机法分为对照组(n=48)和观察组(n=50),对照组给予N-BiPAP治疗,观察组给予气管内滴入牛肺表面活性物质(70~100 mg/kg)辅助N-BiPAP治疗,比较两组患儿通气时间、氧疗时间、血气分析结果、血清炎症因子水平及并发症发生情况。结果:与治疗前比较,治疗后两组患儿动脉二氧化碳分压(PaCO_(2))、降钙素原(PCT)、白细胞介素6(IL-6)、C反应蛋白(CRP)水平降低,动脉血氧分压(PaO_(2))、氧合指标(OI)水平升高(P均<0.05);观察组PaCO_(2)、PCT、IL-6、CRP水平低于对照组,PaO_(2)、OI水平高于对照组(P均<0.05);观察组通气时间、氧疗时间均短于对照组,并发症发生率低于对照组(P均<0.05)。结论:应用气管内滴入牛肺表面活性物质辅助N-BiPAP治疗胎粪吸入综合征的疗效确切,可显著改善血气状态和体内炎症水平,促进患儿早日康复。

Objective:To probe into the efficacy of intratracheal instillation of bovine pulmonary surfactant assisted by nasal biphasic positive airway pressure(N-BiPAP)in the treatment of meconium inhalation syndrome.Methods:Totally 98 children with meconium aspiration syndrome admitted into our hospital from Feb.2016 to Jan.2019 were extracted to be divided into the control group(n=48)and the observation group(n=50)via the simple random method.The control group was treated with N-BiPAP,while the observation group received intratracheal instillation of bovine pulmonary surfactant assisted by N-BiPAP(from 70 to 100 mg/kg).The ventilation time,oxygen therapy time,results of blood gas analysis,levels of serum inflammatory factor and complications were compared between two groups.Results:Compared with before treatment,the levels of arterial partial carbon dioxide pressure(PaCO_(2)),procalcitonin(PCT),interleukin-6(IL-6)and C-reactive protein(CRP)in both groups decreased after treatment,while the levels of arterial partial oxygen pressure(PaO_(2))and oxygenation index(OI)increased(P<0.05).The levels of PaCO_(2),PCT,IL-6 and CRP in the observation group were lower than those in the control group,and the levels of PaO_(2) and OI in the observation group were higher than those in the control group(P<0.05).The ventilation time and oxygen therapy time in the observation group were shorter than those in the control group,and the incidence of complications was lower than that in the control group(P<0.05).Conclusion:The efficacy of intratracheal instillation of bovine pulmonary surfactant assisted by N-BiPAP in the treatment of meconium inhalation syndrome is remarkable,which can significantly improve the blood gas status and the levels of inflammation in the body,and promote the recovery of children.