摘要
目的:探讨国产肺表面活性物质(pulmonary surfactant,PS)治疗早产儿呼吸窘迫综合征(neonatal respiratory distresssyndrome,NRDS)的临床疗效及安全性。方法:对2009年10月～2010年10月出生的70例呼吸窘迫综合征早产儿进行研究。治疗组42例NRDS患儿气管内注入国产PS后机械通气治疗,对照组28例NRDS患儿单纯应用机械通气治疗。比较两组临床表现、血气分析、机械通气参数、肺X线片转归、机械通气及住院时间、并发症及结局等。结果:治疗组患儿临床症状迅速好转。用药后1 h血气PaO2、pH开始明显上升,PaCO2明显下降(P<0.05或P<0.01)。机械通气参数FiO2、PIP于用药后1 h内明显下调,RR和PEEP分别于用药后6 h、48 h明显下降(P<0.05或P<0.01)。应用国产PS后2～6 h治疗组机械通气参数FiO2明显低于对照组(P2h<0.05,P6h<0.05),PIP值于用药后1～72 h内均明显低于对照组(P<0.05或P<0.01)。治疗组用药2～6 h后,肺X线片显示NRDS病变明显改善(P<0.05),对照组未见明显改善(P>0.05)。治疗组机械通气时间、住院时间较对照组短,但差异无统计学意义(P均>0.05),两组并发症等方面比较差异无统计学意义。结论:应用国产肺表面活性物质治疗早产儿呼吸窘迫综合征安全有效。
Objective：To evaluate the efficacy and safety of the homemade pulmonary surfactant（PS） replacement therapy in premature infants with neonatal respiratory distress syndrome（NRDS）.Methods： The study was made with 70 premature infants with NRDS between October 2009 and October 2010.The homemade PS and assisted ventilations were admitted to 42 premature infants with NRDS and there were 28 premature infants with NRDS that only used assisted ventilation without any PS.The changes of clinical manifestations,results of blood gas,parameters of mechanical ventilation,thoracic X-ray changes,duration of ventilator dependence,days of hospital stay and any complications were then compared.Results： After the homemade PS treatment,the symptoms and signs of NRDS improved obviously and quickly.The blood gas index of PaO2 and pH increased significantly and PaCO2 dropped remarkably in 1 h（P0.05 or P0.01）.The ventilator parameters of FiO2 and PIP dropped significantly in 1 h and the RR and PEEP dropped remarkably in 6 h and 48 h respectively（P0.05 or P0.01）.The FiO2 or PIP in experimental group were remarkably lower than those in control group after the treatment of homemade PS2~6 h（P2h0.05,P6h0.05） or 1~72 h（P0.05 or P0.01）.After the homemade PS treatment,the appearance of thoracic X-ray improved more significantly than those without PS（P0.05）.The duration of assisted ventilation and the days of hospital stay were shortened as compared to the control group,but there were no significant differences between the two groups（P0.05）.There were not any remarkable differences in complications either.Conclusions： The homemade PS is effective and safe for the treatment of NRDS in premature infants.
出处
《儿科药学杂志》
CAS
2011年第4期15-18,共4页
Journal of Pediatric Pharmacy
