气管内滴注肺表面活性物质治疗新生儿肺透明膜病效果分析

Analysis of Efficacy of Hyaline Membrane Disease of Newborn Treated with Pulmonary Surfactant by Endo- tracheal Instillation

目的探讨气管内滴注肺表面活性物质治疗新生儿肺透明膜病的效果及安全性。方法选择新生儿肺透明膜病患儿67例，采用气管内注入单剂肺表面活性物质治疗，观察患儿治疗前后的临床表现、血气、x线胸片以及并发症情况。结果痊愈出院65例（97．01％），死亡2例；给药后患儿氧分压（PO2）和动脉血氧饱和度（SaO2）明显升高（P〈0．05），二氧化碳分压（PCO：）明显下降（P〈0．05），皮肤发绀、青紫状况缓解。24h内复查胸片示肺野透明情况显著改善62例（92．54％），无明显改善4例（5．97％），有合并肺出血影像1例（1．49％）。共发生并发症5例，其中肺炎3例，颅内出血1例，肺出血1例。结论早期应用肺表面活性物质能快速改善肺透明膜病患儿的临床症状，改善肺氧合功能，降低对机械通气的需求，有效减少并发症的发生及病死率。

Objective To study the efficacy and safety of pulmonary surfactant used in hyaline membrane disease （HMD） of newborn treatment. Methods 67 cases of HMD children were treated. And pulmonary surfactant was used by intratracheal instillation. Clinical manifestation, blood gas analysis, X-ray chest film and complication be- fore and after treatment were observed and recorded. Results 65 cases of children were recovered and discharged （97. 01% ） , while 2 cases were dead. The PO2 increased significantly after the surfactant was given （P 〈 0.05 ）, while the PCO2 decreased significantly （P 〈 0.05 ）, and situation of skin cyanosis was relieved. X-ray chest films in 24 hours showed that 62 cases were improved （92.54%）, while 4 cases were not obvious （5.97%）, and there was hem- orrhage image in the last 1 caes （ 1.49% ）. There were 5 cases of complication ,involving 3 cases of pneumonia, 1 ease of intracranial hemorrhage and 1 case of pulmonary hemorrhage. Conclusion Clinical symptoms could be impurved rapidly, pulmonary oxygenation could be ameliorated, the need of mechanical ventilation could he lower and the rate of incidence of complication and death could be reduced effectively by using pulmonary surfactant early.