摘要
【目的】观察比较不同时间使用不同剂量肺表面活性物质(PS)防治新生儿肺透明膜病(NRDS)的疗效。【方法】回顾性分析本院64例早产儿生后不同时间和不同剂量应用PS对NRDS患儿血气、肺功能指标及转归的影响。【结果】生后2h内用药者用药后各时间点(1h、12h、24h)血气、肺功能指标改善,住院天数(131.2h±44.7hVS89.8h±55.6h)与呼吸机使用时间(32.6h±13.2hVS23.5h±11.0h)较出生4h后用药者短(P<0.01,P<0.05)。使用剂量为≥200mg/kg的患儿,其胎龄和出生体重均为最小(P<0.05,P<0.01),且胸片Ⅲ、Ⅳ期所占比例明显增多(P均<0.01),表明其病情最重;但用药后三组各时间点(1h、12h、24h)血气、肺功能指标,发病率?死亡率均无显著性差异(P>0.05)。【结论】早期使用肺表面活性可减轻病情,缩短呼吸机辅助通气时间和住院天数,改善预后;对于病情较重患儿,应早期大剂量给药。
To study the efficacy and clinical value of different doses of pulmonary surfactant （PS） replacement therapy in different time for preventing neonatal respiratory distress syndrome （NRDS）. [Methods] The study was a retrospective analysis. Sixty-four premature infants who were treated with PS were divided into three groups by different treatment time and doses respectively. [Results] Blood gas analysis and lung function index in the group , which was administrated within 2h after delivery, were markedly improved in each point（1h、12h、24h）. Hospital days（131.2h±44.7hVS89.8h±55.6h） and duration of assisted ventilation（32.6h±13.2hVS23.5h±11.0h） in this group were shorter than those in the group which was administrated within 4h after delivery in the group of administration within two hours after delivery （ P〈 0.01, P 〈0.05）. Children who had the smallest gestational age and birth weight（ P 〈0.05, P 〈0.01）, and had the more features with Ⅲ、Ⅳ stage presented in chest X-ray（ P 〈0.01）, which showed severe condition, were administrated by 200 mg/kg. There was no difference in blood gas analysis, lung function index, mob- ility and mortality of three groups in every point （lh, 12h, 24hour） after administration（ P 〉0. 05）. [Conclusion] The results indicate that pulmonary surfactant administrated at early time can alleviate the condition of disease, and decrease the duration of assisted ventilation and hospital days, and improve the prognosis. It is essential to treat the severe patients with the large doses of pulmonary surfactant in the early time.
出处
《医学临床研究》
CAS
2007年第9期1475-1478,共4页
Journal of Clinical Research
