| 摘要: |
| 目的:研究应用机械通气联合肺表面活性物质治疗新生儿重症肺炎合并呼吸衰竭的临床疗效。方法:回顾性分析2012年1月至2015年12月我院收治的76例重症肺炎合并呼吸衰竭新生儿的临床资料,45例使用机械通气联合肺表面活性物质为观察组,31例单用机械通气为对照组,比较分析两组患儿的治疗效果、血气分析指标、乳酸水平、氧合指数、呼吸机参数、机械通气时间、吸氧时间、住院时间、并发症和转归等。结果:观察组治疗后第7天氧合指数为284.48±48.11,与对照组237.88±49.25比较差异有统计学意义( P<0.05)。观察组机械通气时间为(95.46±17.41) h、总吸氧时间为(96.61±18.09) h、住院时间为(21.30±4.60)h,对照组分别为(112.58±20.21) h、(116.72±28.11) h、(27.12±5.14) h(P<0.05)。观察组呼吸机相关肺炎(8.89%)、呼吸机相关肺损伤(2.22%)发生率低于对照组(29.03%、16.13%, P<0.05)。观察组和对照组气胸发生率(4.44% vs 3.23%)、肺出血的发生率(2.22% vs 6.45%) 比较差异无统计学意义(P>0.05)。观察组存活率(95.56%)高于对照组(80.65%,P<0.05)。结论:机械通气联合肺表面活性物质可有效治疗新生儿重症肺炎合并呼吸衰竭,缓解临床症状,改善肺氧合功能,减少并发症和改善预后。 |
| 关键词: 机械通气 肺表面活性物质 新生儿 重症肺炎 呼吸衰竭 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.10.007 |
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| 基金项目: |
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| Effect of Mechanical Ventilation Combined with Pulmonary Surfactant in Neonates with Severe Pneumonia and Respiratory Failure |
| Wu Jinglian |
| (Juancheng County Hospital of Shandong Province, Shandong Heze 274600, China) |
| Abstract: |
| Objective: To evaluate the clinical efficacy of mechanical ventilation combined with pulmonary surfactant in neonates with severe pneumonia and respiratory failure. Methods: Seventy-six cases with severe pneumonia and respiratory failure treated in our hospital between January 2012 and December 2015 were analyzed retrospectively. Seventy six cases were given mechanical ventilation alone (control group, n=31) or in combination with PS (observation group, n=45). Therapeutic efficacy, blood gas parameters, lactate levels, oxygenation index, ventilator parameters, duration of mechanical ventilation, duration of oxygen inhalation, length of hospital stay, complications, and outcomes were observed in both groups. Results: The difference of oxygenation index of observation group (284.48±48.11) and control group (237.88±49.25) in the seventh day was statistically significant (P<0.05). Duration of mechanical ventilation, duration of oxygen inhalation, length of hospital stay in observation group were (95.46±17.41) h, (96.61±18.09) h, (21.30±4.60) h, which were less than the control group of (112.58±20.21) h, (116.72±28.11) h, (27.12±5.14) h(P<0.05). Occurrence rates of ventilator-associated pneumonia, ventilator-associated lung injury in observation group (8.89%,2.22%) were lower than the control group (29.03%, 16.13%, P<0.05). The differences of pneumothorax (4.44% vs 3.22%), pulmonary hemorrhage (2.22% vs 6.45%) had no statistical significance (P>0.05). The survival rate in observation group (95.55%) was higher than the control group (80.65%, P<0.05). Conclusion: Mechanical ventilation combined with pulmonary surfactant can effectively treat neonates with severe pneumonia and respiratory failure, which can effectively relieve symptoms, improve lung oxygenation, reduce complications and improve prognosis. |
| Key words: mechanical ventilation pulmonary surfactant neonates severe pneumonia respiratory failure |
