肺表面活性物质应用于早产儿治疗的效果分析

The analysis of therapeutic effect about the use of pulmonary surfactant in lower than 32 weeks

目的探讨肺表面活性物质(PS)预防<32周早产儿肺透明膜病(HMD)的有效性及临床价值。方法71例<32周早产儿根据有无机械通气分为预防组(51例)和治疗组(20例),两组胎龄、Apgar评分、体重均无明显差异。观察两组的用药剂量、用药后血气变化,HMD的发生情况,并发症及其转归。结果预防组和治疗组PS用药剂量分别为(71·2±18·0)mg/kg和(75·1±21·1)mg/kg(t=0·79,P>0·05)。PS注入前后两组组内对比,pH、PaO2差异显著,显示低氧血症和酸中毒纠正。预防组HMD发生率为27·45%,治疗组发生率为80%(χ2=16·26,P<0·01)。两组的主要并发症除肺感染和脑室出血外,均无明显差异。预防组存活率98·04%,治疗组70%(χ2=9·75,P<0·01)。结论肺表面活性物质对HMD具有预防和治疗作用。

Objective To investigate the efficacy and clinical value about the use of pulmonary surfactant in lower than 32 weeks. Methods According to whether to get mechanical ventilation, 71 cases lower than 32 weeks were divided into preventative group（51 cases） and treated group（20 cases）. The two groups had no evident difference in fetal age, Apgar＇s score and weight. The two group＇s medication dose, change of blood gas after medical treatment,development of HMD, complication and turnover were observed. Results Dose of PS in preventative group and treated group were （71.2±18.0）mg/kg and （75.1 ± 21.1）mg/kg（t = 0.79,P〉0.05）. Contrast between the two groups after infusing PS,pH and PaO2 gained obvious difference,which showed rectification of hypoxemia and acid-intoxication. Preventative group＇s incidence of HMD was 27.45 96 while the treat group＇s was 80 96 （X^2 = 16.26, P 〈 0.01 ）. Main complication between the two groups got no obvious difference, except lung infection and cerebroventricular haemorrhage. Survival rate of preventative group was 98.04 % while the treated group＇ s was 70% （X^2 = 9.75, P 〈 0.01 ）. Conclusion Pulmonary surfactant has the preventative and therapeutic effect to HMD.