肺泡表面活性物质对新生儿急性呼吸窘迫综合征氧合功能的影响

Effect of pulmonary surfactant treatment on oxygenation in neonates with acute respiratory distress syndrome

目的探讨早期应用肺泡表面活性物质（Ps）对新生儿急性呼吸窘迫综合征（ARDs）氧合功能的影响。方法回顾性分析ARDS新生儿的临床资料，并按照是否使用PS分为治疗组及对照组，治疗组经气管插管注入PS70-100mg／kg，其余治疗两组相同。结果共人组64例ARDS新生儿，18例为治疗组，46例对照组。治疗组新生儿在治疗后6、12、24、48h的PaO2／FiO2、呼吸机有效指数均高于对照组，而氧合指数、呼吸指数均低于对照组，差异有统计学意义（P均〈0．05）；治疗组机械通气时间、用氧时间均较对照组缩短，差异有统计学意义（尸均〈0．05）。结论早期应用PS治疗新生儿ARDS可改善肺顺应性及氧合功能，缩短机械通气及氧疗时间，有利于改善预后。

Objective To study the effect of early pulmonary surfaetant （PS） treatment on oxygenation in neonates with acute respiratory distress syndrome （ARDS）. Methods Clinical data of neonates with ARDS were retrospectively analyzed. All neonates with ARDS were divided into control group and treatment group. Neonates in treatment group were given PS at a dose of 70-100 mg/kg through the endotracheal tube. Results Among 64 neonates with ARDS, 18 neonates in treatment group were treated with PS, while other interventions were same with 46 neonates in control group. The PaOJ FiO2 and ventilation efficiency index were statistically higher in treatment group than those in control group at 6 h, 12 h, 24 h and 48 h （P〈0.05）. The oxygenation index and respiratory index were statistically lower in treatment group than those in control group at the same time points （P〈0.05）. Compared with control group, the treatment group also had a significantly shorter duration of assisted ventilation and oxygen treatment （P〈0.05）. Conclusions Early treatment with PS in neonates with ARDS could improve the pulmonary compliance and oxygenation, and reduce the duration of assisted ventilation andoxygen treatment, and thus yield better prognosis.