外源性肺表面活性物质治疗新生儿重症感染性肺炎的临床观察  

Effect of exogenous pulmonary surfactant on neonates with severe infectious pneumonia

作　　者：李萍 张世昌 李怀营 Li Ping;Zhang Shichang;Li Huaiying(Department of Neonatal Intensive Care Unit,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]河南省许昌市中心医院新生儿重症监护室,461000

出　　处：《中国实用医刊》2021年第10期91-94,共4页Chinese Journal of Practical Medicine

摘　　要：目的:探讨外源性肺表面活性物质治疗新生儿重症感染性肺炎的临床效果。方法:抽取许昌市中心医院2016年3月至2020年7月收治的重症感染性肺炎新生儿235例,按随机数字表法分为对照组(91例)和研究组(144例),对照组予以常规治疗,研究组在常规治疗基础上予以外源性肺表面活性物质治疗,比较两组患儿治疗前后血气指标、氧和状态以及肺实变程度的差异性。结果:治疗后24、48 h,两组的动脉血氧分压(PaO_(2))较治疗前升高,动脉血二氧化碳分压(PaCO_(2))较治疗前下降(P<0.05),且研究组的PaO_(2)高于对照组,PaCO_(2)低于对照组(P<0.05)。研究组治疗后24、48 h氧合指数(OI)低于对照组,动脉/肺泡分压比值(a/APO_(2))高于对照组(P<0.05)。两组治疗前临床肺部感染评分(CPIS)分别为(8.16±0.82)分和(8.20±0.78)分,治疗7 d后分别为(4.36±0.81)分和(6.23±0.78)分,研究组低于对照组(P<0.05)。治疗后两组的血清抗凝酶Ⅲ(AT-Ⅲ)及肺表面活性蛋白B(SP-B)水平升高,DD-二聚体(D-D)水平降低(P<0.05),且研究组的AT-Ⅲ、SP-B水平高于对照组,D-D水平低于对照组(P<0.05)。结论:外源性肺表面活性物质应用于新生儿重症感染性肺炎的治疗中,能有效改善患儿的血气指标、氧和状态及AT-Ⅲ、SP-B、D-D的表达水平,降低肺部感染程度,促进胸片吸收。Objective To investigate the effect of exogenous lung surfactant on neonates with severe infectious pneumonia.Methods A total of 235 newborns with severe infectious pneumonia in Xuchang Central Hospital from March 2016 to July 2020 were selected,and divided into control group(91 cases)and study group(144 cases)according to random number table method.The control group received conventional treatment,and the study group were treated with exogenous pulmonary surfactant on the basis of conventional treatment.The blood gas indexes,oxygenation status,and pulmonary consolidation degree before and after treatment were compared between the two groups.Results After 24 and 48 hours of treatment,the partial pressure of oxygen in artery blood(PaO_(2))increased,while the partial pressure of carbon dioxide in artery blood(PaCO_(2))decreased in the two groups(P<0.05).Meanwhile,the study group had higher PaO_(2) and arterial/alveolar oxygen tension ratio(a/APO_(2)),lower PaCO_(2) and oxygenation index(OI)than those in the control group(P<0.05).Before treatment,the clinical pulmonary infection scores(CPIS)of the two groups were(8.16±0.82)and(8.20±0.78),which were(4.36±0.81)and(6.23±0.78)after 7 days of treatment.The study group had lower scores than those in the control group(P<0.05).The levels of serum antithrombinⅢ(AT-Ⅲ)and pulmonary surfactant protein B(SP-B)increased,while DD-dimer(D-D)decreased in the two groups(P<0.05).The study group had higher AT-Ⅲand SP-B,lower D-D than those in the control group(P<0.05).Conclusions Exogenous pulmonary surfactant in the treatment of neonates with severe infectious pneumonia can effectively improve blood gas indexes,oxygenation status,and the expression levels of AT-Ⅲ,SP-B and D-D,reduce the degree of pulmonary in fection and promote chest X-ray absorpion.

关 键 词：新生儿 外源性肺表面活性物质 感染性肺炎 

分 类 号：R722.135[医药卫生—儿科]