早产儿预防性使用肺表面活性物质的临床观察

Clinical observation of prophylactic use of pulmonary surfactant in preterm infant

目的分析胎龄≤30周的早产儿预防性使用肺表面活性物质(PS)对临床结局的影响。方法将本院收治的31例(最终纳入25例)胎龄≤30周的早产儿纳入观察组,生后30 min内即予气管内滴入PS,并使用经鼻持续气道正压通气维持等待转运;将同期同级别同地区的另一家医院转运至同一家医院的52例(最终纳入40例)胎龄≤30周的早产儿纳入对照组,转运前未使用PS,入院后根据病情需要作为治疗性使用PS。比较2组早产儿出院前临床结局的差异。结果 2组早产儿呼吸窘迫综合征(RDS)和支气管肺发育不良(BPD)的患病率、机械呼吸使用率、氧疗天数均有显著差异,2组早产儿的死亡率、早产儿视网膜病变(ROP)、坏死性小肠结肠炎(NEC)的患病率无显著差异。结论早期预防性使用PS可降低RDS的发生率及机械呼吸的使用率,同时缩短氧疗时间,降低BPD的患病率。

Objective To analyze the influence on clinical outcome of prophylactic use of pulmonary surfactant （PS） in preterm infant less than 30 weeks old. Methods Thirty- one preterm infants less than 30 weeks old （finally 25 cases included） in our hospital were assigned to observation group. All of them received PS dripped into trachea 30 min after birth, and waited to be transported via nasal continuous positive airway pressure. Fifty-two preterm infants less than 30 weeks old in another hospital （finally 40 cases） were assigned to control group. They did not receive PS before transporting and the therapeutic use of PS was carried out according to the patient＇ s con- ditions. The differences of clinical outcomes before discharge in the two groups were compared. Re- suits There were significant differences in the incidences of RDS, BPD, mechanical ventilation and the duration of oxygen therapy between the two groups, but there was no significant difference in mortality, incidences of ROP and NEC between the two groups. Conclusion The prophylactic use of PS may reduce the incidence of RDS, the use of mechanical ventilation, the duration of oxygen therapy and the incidence of BPD.