肺表面活性物质治疗早产儿肺透明膜病的临床研究

A Clinical Trial of Pulmonary Surfactant Replacement Therapy in Prematrue Infants with Pulmonary Hyaline Membrane Disease

目的:探讨肺表面活性物质(PS)治疗早产儿肺透明膜病(HMD)的疗效及临床价值。方法:对32例诊断肺透明膜病的早产儿采用气管内快速注入PS,观察使用PS前后的动脉血气变化及机械通气情况。结果:应用PS后患儿皮肤颜色迅速转红,使用PS前后PaO2、PaCO2、pH比较差异显著,23例HMD胸片Ⅰ级、Ⅱ级及2例Ⅲ级患儿只需采用持续气道正压通气、面罩等呼吸支持和氧疗技术,7例Ⅲ级患儿机械通气。治愈率96.88%。结论:PS能有效地改善HMD患儿肺顺应性和氧合功能,缩短机械通气时间,提高治愈率。

Objective： To discuss the clinical value of pulmonary surfactant （PS） in the replacement therapy for premature infants with hyaline membrane disease （HMD）. Methods： PS was administered to 32 cases with HMD, then the changes of the ventilation parameter and the results of blood gas were observed. Results： After PS treatment, the symptoms and signs of the premature infants were improved. The level of PaO2 and pH increased significantly （P 〈 0.05）, and the level of PaCO2 decreased significantly （P 〈 0.05）. 23 cases with Ⅰ level of thoracic x-ray manifestation or with Ⅱ level and 2 with Ⅲ level could only be treated by constant positive airway pressure （CPAP）, mask oxygen inhalation and oxygen therapy, 7 case with Ⅲ level treated by mechanical ventilation, cure rate was 96.9%. Conclusion： The PS could effectively improve pulmonary compliance and oxygenation, reduce, and increase cure rate in premature infants with HMD.