摘要
目的探讨吸入性糖皮质激素辅助肺泡表面活性物质(PS)对胎粪吸入综合征(MAS)患儿血气指标、肺部炎症吸收效果及并发症的影响,为临床治疗提供参考。方法选取2015年3月-2017年3月收治的100例MAS患儿为研究对象,按照随机数字表分为A组和B组,每组各50例。A组患儿给予PS气管内注入,B组患儿在此基础上给予吸入性糖皮质激素辅助治疗。比较两组患儿的近期疗效、吸氧时间、住院时间、肺部炎症吸收率、治疗前后血气分析指标水平及并发症发生率。结果B组患儿近期治疗总有效率显著高于A组(P<0.05)。B组患儿吸氧时间和住院时间均显著短于A组(均P<0.05),肺部炎症吸收率显著高于A组(P<0.05)。治疗后2、6、12及24 h,B组患儿血气分析指标均显著优于A组(均P<0.05)。A组和B组治疗后2、6、12及24 h的氧合指数(OI)和动脉血氧分压与肺泡氧分压比值(PaO_2/FiO_2)均显著优于治疗前(均P<0.05)。B组患儿并发症发生率显著低于A组(P<0.05)。结论吸入性糖皮质激素辅助PS治疗MAS可有效缓解相关症状及体征,加快病情康复,促进肺部炎症吸收,改善血气分析指标,并有助于降低并发症发生风险。
Objective To explore the influence of inhaled corticosteroids assisted with pulmonary surfactant（ PS） on blood gas indexes,pulmonary inflammatory absorption,and complications of children with meconium aspiration syndrome（ MAS）,provide a reference for clinical treatment of MAS. Methods From March 2015 to March 2017,100 children with MAS were selected from Chengdu Women＇s and Children＇s Central Hospital,then they were divided into A group and B group according to random number table,50 children in each group.The children in A group were treated with intratracheal instillation of PS,and the children in B group were trerated with intratracheal instillation of PS and inhaled corticosteroids. The short-term curative effects,oxygen inhalation time,hospitalization time,pulmonary inflammatory absorption rates,blood gas analysis indexes before and after treatment,incidence rates of complications in the two groups were compared.Results The short-term total effective rate in B group was statistically significantly higher than that in A group（ P〈0. 05）. The oxygen inhalation time and hospitalization time in B group was statistically significantly shorter than that in A group（ P〈0. 05）. The pulmonary inflammatory absorption rate in B group was statistically significantly higher than that in A group（ P〈0. 05）. At 2,6,12,and 24 hours after treatment,blood gas analysis indexes in B group were statistically significantly better than those in A group（ P〈0. 05）. Oxygenation indexes（ OI） and ratios of arterial partial pressure of oxygen/alveolar oxygen partial pressure（ PaO2/FiO2） at 2,6,12,and 24 hours after treatment in A group and B group were statistically significantly better than those before treatment（ P〈0. 05）. The incidence rate of complications in B group was statistically significantly lower than that in A group（ P〈0. 05）. Conclusion Inhaled corticosteroids assisted with PS in treatment of children with MAS can efficiently relieve the related symptoms and signs,speed up the rehabilitation process of disease,promote the absorption of pulmonary inflammation,improve blood gas analysis indexes,and reduce the risk of complications.
作者
左立旻
李茂霞
梁玉兰
童煜
ZUO Li-Min;LI Mao-Xia;LIANG Yu-Lan(Chengdu Women＇s and Children＇s Central Hospital, Chengdu, Sichuan 610000, China)
出处
《中国妇幼保健》
CAS
2018年第14期3216-3219,共4页
Maternal and Child Health Care of China
基金
国家自然基金(81401238)
泸州市科技计划项目[2012-S-40(2/5)]
