Abstract: Objective To investigate the effect of pulmonary surfactant (PS) for the treatment of premature tension pneumothorax. Methods Eligible patients diagnosed as tension pneumothorax admitted consecutively to the neonatal intensive care unit (NICU) of the Children's Hospital of Hebei Province from June 2012 to December 2015 were included in the study. The patients with tension pneumothorax were randomized in a random number table method to PS group (n=27) and control group (n=25). All patients were treated in the same neonatal unit and received the same standard therapy throughout the study period. The patients in PS group received PS endotracheal intubation within 1-3 hours after the application of chest drainage. At the same time, Cydn, resistance in airway (Raw), mean airway pressure (MAP), a/APO2 were recorded at 0, 1, 12, 24, 48, 72 h and before evacuation of breathing machine. Chest drainage application time, oxygen exposure time, mechanical ventilation time, hospital stays and complications were also recorded. Results Raw and MAP in two groups were gradually decreased, a/APO2 and Cydn were increased . Result of comparison between two groups showed that, 1 h after using PS, a/APO2 of PS group was higher than that of control group; 12 h after using PS, Cydn of PS group was higher than that of control group; but the Raw and MAP of PS group were lower than those of the control group and there were statistical significances (P﹤0.05). Comparison in groups showed that, a/APO2 and Cydn of PS group were increased at 1 h and 12 h respectively, but MAP and Raw were decreased at 1 h and 12 h respectively (all P﹤0.05). The a/APO2, Cydn, Raw between PS group and control group were statistically different (P﹤0.05) until 24 h. Exposure time of high concentration oxygen (FiO2≥40%) of PS group and control group were (56±18) and (74±29) h, total oxygen exposure (FiO2﹥21%) time were (157±29) and (177±36) h, ventilation time were (128±41) and (151±30) h, chest drainage tube indwelling time were (78±29) and (114±36) h. Of all the above indexes PS group were lower than those of control group (all P < 0.05). Conclusions For neonates with tension pneumothorax, early application of PS after the chest drainage can make the compressed lung expand and recovery pulmonary function in a short period of time, then improve the prognosis of children.
刘淑华 申月波 刘翠青 马莉. 外源性肺表面活性物质对早产儿张力性气胸肺功能的影响[J]. 发育医学电子杂志, 2017, 5(3): 146-151.
LIU Shu-hua, SHEN Yue-bo, LIU Cui-qing, MA Li. The efficacy of pulmonary surfactant for pulmonary function in premature tension pneumothorax. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 146-151.