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目的探讨牛肺磷脂注射液联合鼻塞持续气道正压(NCPAP)治疗重症新生儿胎粪吸入综合征(MAS)的临床疗效。方法 2013年在我科收治的重症MAS病例中选取36例,根据是否使用牛肺磷脂注射液分为2组,对照组给予NCPAP治疗,治疗组采用牛肺磷脂注射液联合NCPAP治疗,动态观察使用牛肺磷脂注射液后4,12,24,48 h患儿的氧分压(Pa O2)和二氧化碳分压(Pa CO2)、吸入氧浓度(Fi O2)及呼吸末正压(PEEP)的情况,并统计NCPAP通气时间、氧疗时间、改行有创机械通气病例数。结果在治疗后各时间点,治疗组的血Pa O2、血p H值高于对照组,血Pa CO2﹑吸氧浓度和PEEP低于对照组,同时,治疗组的CPAP使用时间﹑氧疗时间﹑改行有创机械通气病例数低于对照组,差异有统计学意义(P<0.05)。结论牛肺磷脂注射液联合NCPAP治疗重症MAS效果显著。
Objective To investigate the clinical efficacy of bovine pulmonary phospholipid injection combined with nasal continuous positive airway pressure (NCPAP) in the treatment of severe neonatal meconium aspiration syndrome (MAS). Methods Thirty-six cases of severe MAS were enrolled in our department in 2013. The patients were divided into two groups according to whether they were treated with bovine lecithin or not. The control group was treated with NCPAP. The treatment group was treated with bovine pulmonary phospholipid injection combined with NCPAP. Bovine pulmonary phospholipid injection at 4,12,24,48 h after the patient’s partial pressure of oxygen (Pa O2) and partial pressure of carbon dioxide (Pa CO2), inhaled oxygen concentration (Fi O2) and positive end-expiratory pressure (PEEP) , And statistics NCPAP ventilation time, oxygen therapy time, diverted invasive mechanical ventilation cases. Results At each time point after treatment, the blood Pa O2 and blood p H values in the treatment group were higher than those in the control group, and the PaCO 2 ﹑ oxygen concentration and PEEP in the treatment group were lower than those in the control group. Meanwhile, the CPAP use time, oxygen therapy time The number of invasive mechanical ventilation was lower than that of the control group, the difference was statistically significant (P <0.05). Conclusion bovine pulmonary phospholipid injection combined with NCPAP treatment of severe MAS significant effect.