肺表面活性物质治疗婴幼儿急性呼吸窘迫综合征的临床研究

目的探讨肺表面活性物质治疗婴幼儿急性呼吸窘迫综合征的临床疗效。方法选取本院2008年1月-2011年6月收治的婴幼儿急性呼吸窘迫综合征患者54例，随机分为两组，采用机械通气和常规治疗的患儿为对照组（27例），在对照组治疗基础上使用肺表面活性物质治疗的患儿为观察组（27例），比较两组患儿治疗后的各项临床指标。结果观察组动脉血氧分压和动脉血氧分压／肺泡氧分压比值均明显高于对照组，而观察组氧合指数明显低于对照组，差异均有统计学意义（P〈0．05）。观察组呼吸机参数吸气峰压、平均呼吸道压、吸入氧体积分数均明显低于对照组，差异均有统计学意义（P〈0．05），而观察组呼吸机参数呼气末正压与对照组无差异。观察组住院天数、用氧天数、机械通气天数均明显少于对照组，差异均有统计学意义（P〈0．05）。观察组总有效率（96.3％）明显高于对照组（77．8％），差异有统计学意义（P〈0．05）。结论采用肺表面活性物质治疗婴幼儿急性呼吸窘迫综合征可以有效改善患儿的氧合功能，降低呼吸机的使用条件和缩短患儿的用氧时间，还可以大大缩短患儿的住院时间和机械通气时间，减少患儿并发症的发生．是一种安全有效的治疗方法，值得临床推广使用。

Clinical research on infants with acute respiratory distress syndrome in the treatment of pulmonary surfactant

Objective To investigate the clinical efficacy of infants with acute respiratory distress syndrome in the treatment of pulmonary surfactant.Methods 54 infants with acute respiratory distress syndrome were selected in the hospital from January 2008 to June 2011,who were randomly divided into two groups.27 children patients used mechanical ventilation and conventional therapy as the control group.Basing on the treatment in the control group,27 children patients used pulmonary surfactant in the treatment as the observation group.The clinical indexes were compared between the two groups before and after the treatment.Results The PaO2 and PaO2/alveolar oxygen partial pressure ratio in the observation group were significantly higher than those in the control group.The oxygenation index in the observation group was significantly lower than that in the control group.The difference was statistically significant(P < 0.05).The ventilator parameters peak inspiratory pressure,mean airway pressure,inhalation of oxygen volume fraction in the observation group were significantly lower than those in the control group,while the differences were statistically significant(P < 0.05).The parameters of mechanical ventilation with positive end expiratory pressure in the observation group and the control group had no significant difference.The length of hospital stay,days of mechanical ventilation with oxygen,stay in the observation group were significantly less than those in the control group,while the differences were statistically significant(P < 0.05).The total effective rate(96.3%) in the observation group was significantly higher than that in the control group(77.8%),the difference was statistically significant(P < 0.05).Conclusion Using pulmonary surfactant therapy in infants with acute respiratory distress syndrome can effectively improve children’s oxygen and function,which can also reduce the use of respirator and shorten the time of children with oxygen.That can greatly shorten the time of hospitalization and the duration of mechanical ventilation,which can also reduce infant complications.That is a safe and effective treatment method,which is worthy of clinical use.