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目的:探讨不同剂量猪肺磷脂注射液(固尔苏)治疗重症胎粪吸入综合征的疗效及安全性。方法:选取我院100例重症胎粪吸入综合征患儿,随机分为大剂量组和小剂量组,大剂量组给予猪肺磷脂注射液200 mg/kg,小剂量组给予猪肺磷脂注射液100 mg/kg,观察治疗前及治疗后2 h、24 h两组患儿血气指标变化情况,并比较两组患儿机械通气时间、住院时间、住院总费用及固尔苏使用情况。结果:治疗后2 h、24 h两组患儿p H、Pa O2均升高、Pa CO2均降低,且大剂量组血气指标改善较显著(P<0.05);大剂量组患儿机械通气时间、住院时间均短于小剂量组(P<0.05);住院总费用大剂量组低于小剂量组,但差异无统计学意义(P>0.05);大剂量组患儿固尔苏的使用次数少于小剂量组(P<0.05),使用总量也小于小剂量组,差异无统计学意义(P>0.05)。随访至2015年7月30日,大剂量组患儿的病死率与气漏发生率明显低于对照组(P<0.05)。结论:首次大剂量使用猪肺磷脂注射液治疗新生儿重症胎粪吸入综合征的临床疗效明显优于小剂量,可有效改善患儿的肺氧合功能,缩短机械通气时间和住院时间,减少固尔苏的使用次数和总量,从而减少辅助通气的应用,值得临床推广应用。
Objective: To investigate the efficacy and safety of different doses of porcine pulmonary phospholipid injection (Cure Su) in the treatment of severe meconium aspiration syndrome. Methods: One hundred children with severe meconium aspiration syndrome in our hospital were randomly divided into high-dose group and low-dose group. The high-dose group was given 200 mg / kg of lung phoxim and the low-dose group was given pulmonary phlebitis injection 100 mg / kg. The changes of blood gas indexes in both groups before and after treatment for 2 h and 24 h were observed. The mechanical ventilation time, length of hospital stay, total cost of hospitalization and the use of Curel were compared between the two groups. Results: The levels of p H, Pa O2 and Pa CO2 were all decreased in both groups at 2 h and 24 h after treatment, and the blood gas indexes in the high-dose group improved significantly (P <0.05). The mechanical ventilation time (P <0.05). The total cost of hospitalization in the high-dose group was lower than that of the low-dose group, but the difference was not statistically significant (P> 0.05). The number of patients in the high-dose group Less than the low-dose group (P <0.05), the total amount of use is less than the low-dose group, the difference was not statistically significant (P> 0.05). Follow-up to July 30, 2015, the mortality rate and the incidence of air leakage in high-dose group were significantly lower than those in control group (P <0.05). Conclusion: The first high-dose oral administration of porcine pulmonary lecithin injection in neonatal severe meconium aspiration syndrome clinical efficacy was significantly better than low-dose, which can effectively improve children’s pulmonary oxygen function, shorten the duration of mechanical ventilation and hospital stay, reduce the solid Ersu use the number and total, thus reducing the application of assisted ventilation, it is worth clinical application.