早期应用固尔苏预防早产儿呼吸窘迫综合征的临床研究

Protective effect of prophylactic administration of Curosurf in prevention neonatal respiratory disease syndrome of premature

目的分析早产儿生后早期(2h内)使用固尔苏预防早产儿呼吸窘迫综合征(neonatal respiratory disease syndrome,NRDS)的临床疗效。方法将65例胎龄27～32周,体重900～1 500g的早产儿随机分为两组,治疗组30人,生后2h内气管内滴入固尔苏,剂量100～200mg/kg;对照组35人不用固尔苏,仅给予通畅呼吸道、氧疗,两组患儿均给予相同的综合治疗,比较两组发生NRDS的比例,需要呼吸机治疗的比例、机械通气的时间及胸片改变的严重程度。同时在生后12h内监测血气分析。结果 1)治疗组发生NRDS的比例,需要呼吸机治疗的例数及上机时间较对照组少,两者比较差异有统计学意义(P<0.05);2)两组发生NRDS的患儿胸片改变治疗组比对照组程度轻;3)48h内各时段PaO2、PaCO2、PH治疗组与对照组比较均有明显改善。结论对具有发生NRDS高风险的早产儿生后早期预防性应用固尔苏可以降低NRDS发病率、减轻NRDS的严重程度,减少并发征。

Objective To investigate the efficacy of early use of Curosurf in prevention neonatal respiratory disease syndrome of premature （NRDS）. Methods Sixty-five premature infants, whose gestational age of 27 - 32 weeks, and birth weight of 900-1 500 g,were randomly allocated to treated group and control group. 30 neonates of treated group were dripped in with Curosurf through trachea within 2 hours of life （100-200 mg/kg） and 35 of control group without. It was same integrated therapy procedure to both treated group and control group. The incident of NRD$, the rate and period of mechanical ventilation dependence, the degree of chest X-rag, the levels of blood gas analysis were compared in two groups. Results The incident of NRDS,the rate and period of mechanical ventilation dependence,the degree of chest X-rag were less in treated group than in control group. The levels of blood gas analysis were better in treated group than those in control group. Conclusion Prophylactic administration of Curosurf to the premature with high risk of NRDS can decrease the in- cident of NRDS,devetopment of severe cases,shorten the disease course, reduce early and late complications.