Chen Dong-Mei, Wu Lian-Qiang, Wang Rui-Quan
Department of Neonatology, Quanzhou Women and Children's Hospital Quanzhou 362000, Fujian Province, China.
Int J Clin Exp Med. 2015 Aug 15;8(8):14490-6. eCollection 2015.
The aim of this study was to investigate the clinical efficiency of the use high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) for the treatment of neonatal meconium aspiration syndrome (MAS). Clinical data of 53 MAS patients admitted to neonatal intensive care unit (NICU) was collected and the patients were divided into 3 groups according to the different treatment approach: group 1 conventional mechanical ventilation (CMV); group 2 HFOV; group 3 HFOV + PS. By monitoring the changes in oxygenation function indicators such as inhaled oxygen concentration (FiO2), oxygenation index (OI) and arterial oxygen tension/alveolar arterial oxygen tension (a/ApO2) of three groups after 2, 12, 24, 48 h of treatment, the usage of the ventilator, duration of hospitalization, changes in clinical manifestations and outcomes of three groups were analyzed. As compared to group 1, the difference in all the oxygenation function indicators after treatment in group 2 and group 3 was statistically significant at different points in time (P < 0.05). However, the timing and extent of the change in the indicators in group 3 were more significant than in group 2; as compared to group 1, the ventilation time, duration of the oxygen therapy and hospitalization time of group 2 and group 3 were significantly shorter and the difference was statistically significant (P < 0.05). Early use of HFOV combined with PS to treat MAS has significant therapeutic effect, especially for the treatment of severe MAS where it can be used as a safer and more effective rescue measure.
本研究旨在探讨高频振荡通气(HFOV)联合肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的临床疗效。收集新生儿重症监护病房(NICU)收治的53例MAS患者的临床资料,根据不同治疗方法将患者分为3组:第1组为传统机械通气(CMV);第2组为HFOV;第3组为HFOV + PS。通过监测三组治疗2、12、24、48小时后吸入氧浓度(FiO2)、氧合指数(OI)、动脉血氧分压/肺泡动脉血氧分压差(a/ApO2)等氧合功能指标的变化,分析三组呼吸机使用情况、住院时间、临床表现变化及预后。与第1组相比,第2组和第3组治疗后各时间点的所有氧合功能指标差异均有统计学意义(P < 0.05)。然而,第3组指标变化的时间和程度比第2组更显著;与第1组相比,第2组和第3组的通气时间、氧疗时间和住院时间明显缩短,差异有统计学意义(P < 0.05)。早期使用HFOV联合PS治疗MAS具有显著的治疗效果,尤其对于重症MAS的治疗,可作为一种更安全有效的抢救措施。