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目的研究探讨肺表面活性物质(PS)对新生儿胎粪吸入综合征(MAS)的肺氧合功能的影响。方法采用气管内滴入PS治疗10例MAS患儿,对用药前、用药后30 min、2 h及6 h血气指标,机械通气参数进行比较分析,判断肺氧合情况。结果 10例患儿血气指标及机械通气的参数用药前与用药30 min后比较差异有统计学意义(P<0.05),动脉血氧分压(Pa O2)由(42.81±4.68)mm Hg(1 mm Hg=0.133 k Pa)升高至(55.19±4.82)mm Hg,动脉与肺泡氧分压比值(a/APO2)由(0.11±0.06)升高至(0.20±0.05),动脉血氧分压与吸入氧浓度比值(Pa O2/Fi O2)由(67.04±18.00)mm Hg升高至(97.13±24.14)mm Hg,Fi O2由(0.66±0.10)降至(0.54±0.08),平均气道压(MAP)由(15.52±3.15)cm H2O(1 cm H2O=0.098 k Pa)降至(11.67±2.85)cm H2O。氧合指数(OI)由(22.16±2.12)降至(14.16±1.67),差异均具有统计学意义(P<0.05)。结论肺表面活性物质能有效地改善MAS患儿肺氧合功能。
Objective To investigate the effects of pulmonary surfactant (PS) on pulmonary oxygenation in neonates with meconium aspiration syndrome (MAS). Methods 10 children with MAS were treated with PS via intra-tracheal instillation. The blood gas indexes and mechanical ventilation parameters before treatment, 30 min, 2 h and 6 h after drug administration were compared and analyzed to determine the pulmonary oxygenation. Results The parameters of blood gas and mechanical ventilation in 10 children were statistically significant (P <0.05) before and 30 minutes after treatment. PaO2 was decreased from (42.81 ± 4.68) mm Hg (Hg = 0.133 k Pa) to (55.19 ± 4.82) mm Hg, the ratio of arterial to alveolar oxygen pressure (a / APO2) increased from (0.11 ± 0.06) to (0.20 ± 0.05) (PaO2 / Fi O2) increased from (67.04 ± 18.00) mm Hg to (97.13 ± 24.14) mm Hg, FiO2 decreased from (0.66 ± 0.10) to (0.54 ± 0.08), mean airway The pressure (MAP) decreased from (15.52 ± 3.15) cm H2O (1 cm H2O = 0.098 kPa) to (11.67 ± 2.85) cm H2O. Oxygenation index (OI) decreased from (22.16 ± 2.12) to (14.16 ± 1.67), the differences were statistically significant (P <0.05). Conclusion Pulmonary surfactant can effectively improve pulmonary oxygenation in children with MAS.