肺表面活性物质用于新生儿重症肺炎的价值  

Value of pulmonary surfactant in treatment of neonatal severe pneumonia

作　　者：孙明华[1] 

机构地区：[1]濮阳市人民医院儿科,河南濮阳457000

出　　处：《现代临床医学》2017年第5期358-360,共3页Journal of Modern Clinical Medicine

摘　　要：目的:探讨肺表面活性物质(PS)对新生儿重症肺炎患儿肺部氧合情况及血气指标的影响。方法:选取新生儿重症肺炎患儿62例,随机分为治疗组和对照组,各31例。所有患儿均进行常规治疗,接呼吸机,治疗组患儿肺部接受PS治疗。比较2组患儿治疗前后肺部氧合情况,对治疗组PS治疗前后血气指标进行分析,并统计2组平均机械通气时间、氧暴露时间及死亡病例和原因。结果:治疗后10 min、30 min、60 min时2组患儿血氧饱和度(SpO_2)均较治疗前升高,且治疗组明显高于对照组(P<0.01);治疗后24 h、48 h、72 h时2组患儿氧合指数(OI)均降低,且治疗组明显低于对照组(P<0.01);治疗组患儿经PS治疗后30 min、60 min时血氧分压/吸入氧浓度比值(PO2/FiO_2)及动脉/肺泡氧分压比值(a/APO_2)均呈先升高后降低趋势,但均明显高于治疗前(P<0.01);治疗组平均机械通气时间和平均氧暴露时间均明显低于对照组(P<0.01);2组病死率比较有显著性差异(P<0.05)。结论:PS可以显著改善新生儿重症肺炎患儿肺部氧合状态及低氧血症,值得临床推广使用。Objective： To explore the effect of pulmonary surfactant（ PS） on lung oxygenation and blood gas indexes in neonates with severe pneumonia. Methods： 62 neonates with severe pneumonia were randomly divided into treatment group and control group,31 cases in each group. All neonates received conventional therapy and were connected to the ventilator,and those in the treatment group were additionally given PS in lung. The lung oxygenation before and after treatment was compared between the two groups. The blood gas indexes before and after PS treatment in the treatment group were analyzed,and the average mechanical ventilation time,oxygen exposure time and death cases and its causes in the two groups were statistically analyzed.Results： Compared with pretreatment,the SpO2 of the two groups all increased 10,30 and 60 min after treatment and the treatment group had significantly higher SpO2 than the control group（ P 〈 0. 01）. The OI of the two groups all decreased 24,48,72 h after treatment,and the OI of treatment group was significantly lower than that of control group（ P 〈 0. 01）. In the treatment group,the PO2/FiO2 and a/APO2 all increased at first and then decreased 30 min and 60 min after PS treatment,but they were all significantly higher than those before treatment（ P 〈 0. 01）. The average time of mechanical ventilation and oxygen exposure time in the treatment group were significantly lower than those in the control group（ P 〈 0. 01）. Case fatality rate showed significant difference between the two groups（ P 〈 0. 05）. Conclusion： PS can significantly improve the pulmonary oxygenation status and hypoxemia in neonates with severe pneumonia. It is worthy of clinical application.

关 键 词：新生儿重症肺炎 肺表面活性物质 肺部氧合 血气 

分 类 号：R722.135[医药卫生—儿科]