改良法注入肺表面活性物质治疗新生儿肺内/肺外源性急性肺损伤的疗效观察

摘要

目的:探讨改良法注入肺表面活性物质(PS)治疗新生儿肺内/肺外源性急性肺损伤的临床效果.方法:将肺内/肺外源性急性肺损伤新生儿72例根据随机数字表法分为观察组与对照组各36例,对照组采用传统法注入PS治疗,观察组采用改良法注入PS治疗.2组患儿均在治疗前后进行无创经皮氧饱和度测定,测定指标包括动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)等.评价2组疗效;观察2组患儿的通气时间、氧疗时间与住院时间及并发症情况.结果:观察组的有效率97.2％,高于对照组的83.3％(P<0.01).治疗后观察组的PaO2与PaCO2值改变与对照组比较差异均有统计学意义(P<0.01).观察组的通气时间、氧疗时间与住院时间均少于对照组(P<0.01).观察组的气胸、呼吸暂停、肺部感染等并发症发生情况均少于对照组(P<0.05～P<0.01).结论:改良法注入PS治疗新生儿肺内/肺外源性急性肺损伤能有效改善血气指标,减少并发症的发生,提高总体疗效,促进患儿康复.%Objective:To investigate the clinical effects of injection pulmonary surfactant(PS)using modified method in the treatment of endogenous and exogenous acute lung injury of newborns.Methods:Seventy-two newborns with endogenous or exogenous acute lung injury were randomly divided into the observation group and control group according to random number table(36 cases each group).The control group and observation group were injected with PS using traditional and modified method,respectively.The non-invasive percutaneous oxygen saturation,which included arterial oxygen partial pressure(PaO2)and arterial carbon dioxide partial pressure(PaCO2),in two groups were determined before and after treatment.The clinical efficacy of two groups was evaluated.The ventilation time,oxygen treatment time,hospitalization time and complications in two groups were observed.Results:The effective rate in treatment group(97.2％)was higher than that in control group(83.3％)(P<0.01).Compared with the control group,the differences of the changes of PaO2 and PaCO2 value in observation group were statistically significant(P<0.01).The ventilation time,duration of oxygen therapy and hospitalization time in observation group were less than those in control group(P<0.01).The incidence rates of pneumothorax,apnea,lung infection in observation group were less than those in control group(P<0.05 to P<0.01).Conclusions:The injection PS using modified method in treating endogenous and exogenous acute lung injury of newborns can effectively improve the blood indicators,reduce complications,increase the overall effect and promote the rehabilitation of children.