高频振荡通气联合肺表面活性物质治疗新生儿重症胎粪吸入综合征并发持续肺动脉高压的效果及安全性  

Effect and safety of high frequency oscillatory ventilation combined with pulmonary surfactant in the treatment of neonatal severe meconium aspiration syndrome complicated with persistent pulmonary hypertension

作　　者：孙义娟 皮玉香 SUN Yi-juan;PI Yu-xiang(The Third Department of Pediatrics,Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市中医医院儿三科,陕西安康725000

出　　处：《海南医学》2022年第20期2665-2667,共3页Hainan Medical Journal

摘　　要：目的研究高频振荡通气联合肺表面活性物质治疗新生儿重症胎粪吸入综合征并发持续肺动脉高压的效果及安全性。方法回顾性分析安康市中医医院2018年2月至2021年3月期间收治的60例重症胎粪吸入综合征并发持续肺动脉高压患儿的诊疗情况。按治疗方法的不同将其分为研究组和对照组各30例。对照组患儿给予高频振荡通气治疗,研究组患儿给予高频振荡通气联合肺表面活性物质治疗。两组患儿均连续治疗2周,比较两组患儿治疗前后的动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、氧合指数(OI)水平,以及通气时间、用氧时间、住院时间和不良反应发生情况。结果治疗前,两组患儿的PaCO_(2)、PaO_(2)、OI水平比较差异均无统计学意义(P>0.05);治疗后,两组患儿的PaCO_(2)、OI水平均明显降低,且研究组患儿的PaCO_(2)、OI水平分别为(40.56±4.86)mmHg、18.49±2.54,明显低于对照组的(56.12±5.03)mmHg、22.36±2.78,差异均有统计学意义(P<0.05),但两组患儿的PaO_(2)水平明显升高,且研究组为(78.56±6.43)mmHg,明显高于对照组的(65.76±5.13)mmHg,差异均有统计学意义(P<0.05);研究组患儿的通气时间、用氧时间、住院时间分别为(80.56±5.89)h、(140.28±8.46)h、(12.46±1.87)d,明显低于对照组的(112.48±6.12)h、(185.26±10.49)h、(17.54±2.06)d,差异均有统计学意义(P<0.05);研究组和对照组患儿的总不良反应发生率分别为6.67%、8.33%,差异无统计学意义(P>0.05)。结论高频振荡通气联合肺表面活性物质治疗新生儿重症胎粪吸入综合征并发持续肺动脉高压能够改善患儿的肺氧合功能,缩短通气时间、用氧时间、住院时间,临床应用效果显著,且具有一定的安全性,值得临床推广。Objective To study the effect and safety of high frequency oscillatory ventilation combined with pulmonary surfactant in the treatment of neonatal severe meconium aspiration syndrome complicated with persistent pulmonary hypertension.Methods The diagnosis and treatment of 60 children with severe meconium aspiration syndrome complicated with persistent pulmonary hypertension treated in Ankang Hospital of Traditional Chinese Medicine from February 2018 to March 2021 were retrospectively analyzed.According to different treatment methods,they were divided into a study group(n=30)and a control group(n=30).The children in the control group were treated with high-frequency oscillatory ventilation,and the children in the study group were treated with high-frequency oscillatory ventilation combined with pulmonary surfactant.Both groups of children were treated for 2 weeks.The levels of arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),oxygenation index(OI),ventilation time,oxygen use time,length of hospital stay,and adverse reactions before and after treatment were compared between the two groups.Results Before treatment,there was no significant difference in the levels of PaCO_(2),PaO_(2),and OI between the two groups(P>0.05).After treatment,the levels of PaCO_(2) and OI in the two groups were significantly decreased,and the levels in the study group were(40.56±4.86)mmHg and 18.49±2.54,significantly lower than(56.12±5.03)mmHg and 22.36±2.78 in the control group(P<0.05);but the levels of PaO_(2) in the two groups were significantly increased,and the levels in the study group were(78.56±6.43)mmHg,significantly higher than(65.76±5.13)mmHg in the control group(P<0.05).The ventilation time,oxygen use time,and length of hospital stay in the study group were(80.56±5.89)h,(140.28±8.46)h,and(12.46±1.87)d,which were significantly lower than(112.48±6.12)h,(185.26±10.49)h,and(17.54±2.06)d in the control group(P<0.05).The total incidence of adverse reactions in the study gr

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

分 类 号：R722[医药卫生—儿科]