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目的探讨高频振荡通气与肺表面活性物质联合治疗新生儿胎粪吸入综合征(MAS)的临床疗效。方法选取2015年4月—2016年7月漯河市中心医院72例MAS患儿,根据治疗方案分组,各36例。在常规治疗基础上,对照组给予高频振荡通气治疗,观察组给予高频振荡通气+肺表面活性物质治疗。对比两组治疗前及治疗后不同时段动脉氧分压(PaO_2)、二氧化碳分压(PaCO_2)及氧合指数(OI)水平,并统计不良反应发生率。结果治疗前,两组PaO_2、PaCO_2及OI水平比较差异无统计学意义(P>0.05),治疗后3h、12h、24h观察组PaO_2高于对照组,PaCO_2、OI低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率8.33%与对照组5.56%比较,差异无统计学意义(P>0.05)。结论给予新生儿MAS肺表面活性物质与高频振荡通气联合治疗,临床效果显著,且具有一定安全性。
Objective To investigate the clinical effects of high frequency oscillatory ventilation and pulmonary surfactant in the treatment of neonatal meconium aspiration syndrome (MAS). Methods From April 2015 to July 2016, 72 children with MAS in Luohe Central Hospital were enrolled and divided into three groups according to the treatment regimen: 36 cases each. On the basis of routine treatment, the control group was treated by high-frequency oscillatory ventilation, and the observation group was given high-frequency oscillatory ventilation + pulmonary surfactant treatment. The arterial oxygen pressure (PaO_2), PaCO_2 and oxygenation index (OI) before and after treatment were compared between two groups, and the incidence of adverse reactions was calculated. Results Before treatment, there was no significant difference in PaO_2, PaCO_2 and OI between the two groups (P> 0.05). The PaO_2 in the observation group at 3h, 12h and 24h after treatment were higher than those in the control group, PaCO_2 and OI were lower than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was 8.33% compared with 5.56% in the control group, with no significant difference (P> 0.05). Conclusions The combination therapy of neonatal MAS pulmonary surfactant with high-frequency oscillatory ventilation has significant clinical effect and certain safety.