摘要
【目的】探讨肺表面活性物质(pulmonary surfactant,PS)对小儿麻疹肺炎合并急性呼吸窘迫综合征(acuterespiratory distress syndrome,ARDS)的治疗作用。【方法】26例确诊为麻疹肺炎并ARDS患儿,其中11例采用气管插管滴入PS(PS治疗组),15例常规治疗未用PS(常规组),观察PS治疗组用药前、后呼吸机参数,血气分析变化,比较PS治疗组和常规治疗组血气分析、肺部X线表现及预后。【结果】①治疗组用药后12 h对比:呼吸频率(RR)、吸入氧分数(FiO2)、吸气峰压[PIP(cmH2O)]、呼气末正压[PEEP(cmH2O)]、平均气道压[MAP(cmH2O)]等呼吸机参数明显下调,差异有显著性(P<0.05或<0.01);②用药后24 h治疗组血气PH、PaO2、PaCO2显著改善,与常规组比较差异有显著性(P<0.01);③用药后24 h治疗组胸片较常规组明显好转;④治疗组与常规组比较,死亡率明显下降(P<0.01)。【结论】PS对麻疹肺炎合并ARDS有明显疗效。
[Objective] To explore the efficacy of pulmonary surfaetant（PS） replacement therapy on measles complicated with severe pneumonia and acute respiratory distress syndrome in children. [Methods] 26 cases with measles complicated with severe pneumonia and acute respiratory distress syndrome were divided into two groups. 15cases were given conventional therapy（conventional therapy group）. 11 cases received pulmonary surfactant through an endotracheal tube（PS replacement therapy group）, comparing ventilation parameter,arterial gas analysis before and after treatment. Arterial gas analysis,chest X-ray, prognosis were compared between PS replacement therapy group and conventional therapy group. [Results] （1）After given PS 12 hours, the ventilation parameters, including RR, FiO7, PIP（cmH2O）, PEEP（cmH2O）, MAP（cmH2O）,were been down regulation and there were significant difference （P〈0.05 or 〈0.01 ） in the PS replacement therapy group; （2）PH,PaO2 ,PaCO2 were improved significant after 24 hours treatment in replacement therapy group, there were significant difference between two groups （P〈0.01）;（3）Comparing to conventional therapy group, chest X-ray took a favorable turn obviously after 24 hours treatment. （4）Meanwhile, mortality rate of replacement therapy group was lower than conventional therapy group （P〈0.01）. [Conclusion] Pulmonary surfactant is effective in treating measles complicated with severe pneumonia and acute respiratory distress syndrome in children.
出处
《中国儿童保健杂志》
CAS
2008年第6期653-654,657,共3页
Chinese Journal of Child Health Care
基金
北京市自然科学基金(7053080)
首都医学发展基金(20051012)
关键词
麻疹
肺炎
呼吸窘迫综合征
肺表面活性物质
measles
pneumonia
respiratory distress syndrome
pulmonary surfactant
