肺表面活性物质治疗新生儿肺透明膜病的疗效分析

Pulmonary surfactant in treatment of hyaline membrane disease in neonate

目的：探讨肺表面活性物质（pulmonary surfactant，PS）治疗新生儿肺透明膜病（hyaline membrane disease of newborn，HMD）的疗效。方法：对17例HMD患儿气管内给予PS治疗，观察用药后的临床表现、呼吸机参数、血气分析结果、胸片的变化。结果：用药后临床症状和体征改善。机械通气参数吸气峰压（PIP）、呼吸末正压（PEEP）、平均气道压（MAP）和呼吸频率（RR）较治疗前均降低（P〈0．05～P〈0．01）；血气分析PaO2及pH值上升（P〈0．05和P〈0．01），PaCO2下降（P〈0.01）。24h胸片提示肺部病变明显改善。结论：PS治疗HMD可明显改善其转归，减少呼吸机上机时间、住院天数及病死率。

Objective： To explore the effect of pulmonary surfactant （PS） on hyaline membrane disease （HMD） of newborn. Methods： PS was administered to seventeen neonates with HMD ,then the changes of clinical manifestation ,the parameter of mechanical aeration, the results of blood gas and the X-ray presentations of the lung were observed. Results：After medical treatment ,the symptoms and signs of the neonates were improved. The pressure peak of mechanical aeration parameter（ PIP）, positive breath pressure（ PEEP）, average gas trace pressure（MAP） and breath frequency（RR） dropped remarkably（ P〈0.05-P〈0.01 ）. The level of PaO2 and pH increased obviously （ P 〈 0.05 and P 〈 0.01 ）, and the level of PaCO2 decreased greatly （ P 〈 0.01 ）. At 24 hours after treatment, the X-ray presentations improved significantly. Conclusions： PS therapy can improve the pathological changes of HMD, reduce the time of respirator utilization,the time of hospital stay and the fatality rate.