不同通气模式联合猪肺磷脂注射液对新生儿胎粪吸入综合征并肺动脉高压的疗效

Effect of different ventilation modes combined with porcine lung phospholipid injection on neonatal meconium aspiration syndrome complicated with pulmonary hypertension

目的探讨不同通气模式联合猪肺磷脂注射液对新生儿胎粪吸入综合征并肺动脉高压的疗效。方法对2015年1月至2018年12月钦州市妇幼保健院新生儿科收治的116例胎粪吸入综合征并肺动脉高压患儿进行回顾性研究,根据通气方式不同分为高频振荡通气组(62例,A组)和常频机械通气组(54例,B组),对比2组机械通气时间、氧疗时间和住院时间、血气指标、氧合功能指标、肺动脉压力、临床疗效及并发症发生率。结果A组患者机械通气时间、氧疗时间和住院时间均短于B组,差异均有统计学意义(P值均<0.05);通气12、24、48 h后A组PaO2和SaO2均高于B组,差异均有统计学意义(P值均<0.05),PaCO2低于B组,差异有统计学意义(P<0.05);通气12、24、48 h后A组PaO2/FiO2均高于B组,差异均有统计学意义(P值均<0.05),FiO2、氧合指数和肺动脉压力均低于B组,差异均有统计学意义(P值均<0.05);A组的总有效率高于B组,差异有统计学意义(P<0.05);2组并发症发生率差异无统计学意义(P>0.05)。结论高频振荡通气联合猪肺磷脂注射液用于治疗新生儿胎粪吸入综合征并肺动脉高压,能够缩短治疗时间,改善通气和氧合功能,降低肺动脉压,且安全有效。

Objective To explore the effect of different ventilation modes combined with porcine lung phospholipid injection on neonatal meconium aspiration syndrome with pulmonary hypertension.Methods The data of 116 children with meconium aspiration syndrome with pulmonary hypertension treated in Qinzhou Maternal and Child Health Hospital from January 2015 to December 2018 were reviewed,according to different ventilation methods,they divided into high-frequency shock ventilation group(n=62,group A)and constant-frequency mechanical ventilation group(n=54,group B).The mechanical ventilation time,oxygen therapy time and hospitalization time,blood gas indicators,oxygenation function indicators,pulmonary artery pressure,clinical efficacy and the incidence of complications of the two groups were compared.Results The mechanical ventilation time,oxygen therapy time and hospitalization time of group A were shorter than those of group B,and the difference were statistically significant(all P<0.05).After ventilation for 12 h,24 h,and 48 h,PaO2 and SaO2 of group A were higher than group B,and the difference were statistically significant(both P<0.05),and PaCO2 were lower than group B,the difference were statistically significant(both P<0.05).PaO2/FiO2 of group A were higher than group B after ventilation for 12 h,24 h,and 48 h,and the difference were statistically significant(P<0.05).FiO2,oxygenation index and pulmonary artery pressure were all lower than group B,and the differences were all statistical significance(all P<0.05).The total effective rate of group A was higher than that of group B,and the difference were statistically significant(P<0.05).The incidence of complications in the two groups were similar,and the difference were not statistically significant(P>0.05).Conclusions High-frequency oscillatory ventilation combined with porcine lung phospholipid injection for the treatment of neonatal meconium aspiration syndrome with pulmonary hypertension can shorten the treatment time,rapidly improve ventilation and oxygenation function,reduce pulmonary artery pressure,and it is safe and effective.