国产肺表面活性物质珂立苏治疗足月新生儿呼吸窘迫综合征临床疗效评价

Domestic pulmonary surfactant-Calsurf on the treatment of respiratory distress syndrome in full-term neonates

目的观察珂立苏治疗足月新生儿呼吸窘迫综合征(RDS)临床疗效。方法对符合足月新生儿RDS诊断标准、且家长同意使用外源性肺表面活性物质(PS)的患儿,根据家长意愿分为两组,即珂立苏治疗组55例和固尔苏治疗组47例。在相同的综合治疗基础上比较两组患儿补充外源性PS制剂前后的血气变化、主要呼吸机参数、机械通气时间、氧疗天数、住院天数、住院费用以及并发症等情况。结果给予PS制剂后8h、24h、48h两组患儿的氧合及通气功能(PaO2﹑Pa-CO2)明显改善(P<0.01),主要呼吸机参数(PIP﹑PEEP、FiO2)等指标均明显降低(P<0.01),使用珂立苏或固尔苏患儿在各观察点上述指标比较均无差异(P>0.05)。两组患儿的机械通气时间珂立苏组(163.61±76.81)h,固尔苏组(188.57±76.74)h(t=1.560,P=0.122);氧疗天数珂立苏组(11.58±4.64)d,固尔苏组(11.93±4.39)d,t=0.372,P=0.710;住院天数珂立苏组(20.72±6.06)d,固尔苏组(20.14±4.77)d,t=0.212,P=0.832;住院费用珂立苏组(32758.41±10451.24)元,固尔苏组(35980.24±9855.57)元,前者节约9.0%(t=2.084,P=0.037)。两组患儿并发症(MOSF、PPHN、急性肾衰、肺出血、DIC等)发生率均无显著性差异(P>0.05)。结论国产肺表面活性物质珂立苏治疗足月新生儿RDS与进口固尔苏具有相似的疗效,但珂立苏能在一定程度上减少住院费用。

Objective To investigate the therapeutic effect of the domestic pulmonary surfactant（Calsurf） on respiratory distress syndrome（RDS） in full-term neonates.Methods 102 RDS patients were divided into Calsurf treatment group and Cursurf treatment group.On the basis of the same comprehensive treatment of the two groups,changes of oxgenation and parameters of ventilation were measured by comparing pre-treatment and post-treatment values at 8h,24h,48h.PaO2 and PaCO2 were measured.The parameters of ventilation including PIP,PEEP,FiO2 were recorded.Besides,the blood gas analysis,duration of mechanical ventilation and the time needed oxygen therapy,duration of hospitalization,in-hospital costs and complications were compared between the two groups.Results There were no signifancant differences in oxyenation and parameters of ventilation at 8h,24h,48h after treatment between the two groups（P0.05）.The mechanical ventilation were（163.61±76.81）h in Calsurf group and（188.57±76.74）h in Curosurf group,respectively（t=1.560,P=0.122）;the duration of oxygen therapy were（11.58±4.64）d in Calsurf group and（11.93±4.39）d in Curosurf group,respectively（t=0.372,P=0.710）;duration of hospitalition were（20.72±6.06）d in Calsurf group and（20.14±4.77）d in Curosurf group,respectively（t=0.212,P=0.832）;in-hospital costs were（32758.41±10451.24） yuan in Curosurf group and（35980.24±9855.57）yuan in Calsurf group,the former saved 9.0%（t=2.084,P=0.037）.The incidences of complications of two groups showed no significant differences（P0.05）.Conclusion Both Calsurf and Curosurf have similar effects on treatment of respiratory distress syndrome in full-term neonates.But Calsurf can reduce in-hospital costs.