肺表面活性物质与高频振荡通气联合治疗胎粪吸入综合征合并新生儿持续性肺动脉高压的临床分析  

Clinical Analysis of Pulmonary Surfactant Combined with High Frequency Oscillatory Ventilation in Treatment of Meconium Aspiration Syndrome with Persistent Pulmonary Hypertension of Newborns

作　　者：朱伟[1] 姜凤朝[1] 孟琼[1] 游楚明[1] ZHU Wei;JIANG Fengchao;MENG Qiong;YOU Chuming(The 2nd People’s Hospital of Guangdong Province,Guangzhou 510317,China;不详)

机构地区：[1]广东省第二人民医院,广东广州510317

出　　处：《现代医院》2020年第10期1532-1534,1538,共4页Modern Hospitals

基　　金：广东省科技计划项目(2017ZC0255)。

摘　　要：目的探讨肺表面活性物质(PS)与高频振荡通气(HFOV)联合治疗胎粪吸入综合征(MAS)合并新生儿持续性肺动脉高压(PPHN)的疗效及安全性。方法选取诊断MAS合并PPHN并需机械通气的新生儿32例,按照是否使用PS分为治疗组(PS,n=17)和对照组(C,n=15)。治疗组在机械通气前通过经气管插管注入PS 120mg其余两组治疗相同。在治疗前及治疗后24 h、48 h测量动脉血气、氧合指数、肺动脉收缩压;并对患儿机械通气时间、住院治疗时间、并发症发生率等进行分析。结果治疗组肺动脉收缩压、PaCO2、0I下降幅度较对照组明显;PaO2升高较对照组显著差异有统计学意义(P <0.05),在机械通气时间、住院时间、主要并发症发生率方面两组差异无统计学意义。结论肺表面活性物质与高频振荡通气联合应用治疗MAS合并PPHN在降低肺动脉压力、改善氧合方面优于对照组,安全有效,未增加并发症的发生。Objective To study the efficacy and safety of pulmonary surfactant( PS) combined with High-frequency oscillatory ventilation( HFOV) in treatment of meconium aspiration syndrome( MAS) with persistent pulmonary hypertension of newborns( PPHN). Methods 32 cases of newborns diagnosed as MAS with PPHN and needed mechanical ventilation were selected and divided into two groups: the treatment group( PS,n = 17) and the control group( C,n = 15)according to whether to use PS. The treatment group were given PS at a dose of 120 mg through the endotracheal tube before mechanical ventilation,and the control group received the same treatment. Arterial blood gas analysis and oxygenation index( OI) were monitored,and pulmonary arterial systolic pressure was tested 24 h and 48 h before and after the treatment. Time of mechanical ventilation and hospitalization and incidence of complications were analyzed. Results Compared with the control group,pulmonary arterial systolic pressure,PaCO2,and oxygenation index( OI) in the treatment group decreased prominently,and PaO2 improved significantly;the differences were statistically significant respectively( P < 0. 05),and there was no significant difference in time of mechanical ventilation and hospitalization and incidence of complications. Conclusion PS combined with HFOV were effective and safe to decrease the pulmonary arterial pressure and improve OI in treatment MAS with PPHN without increasing the incidence of complications.

关 键 词：肺表面活性物质 高频振荡通气 胎粪吸入综合征 持续性肺动脉高压 新生儿 

分 类 号：R722[医药卫生—儿科]