国产牛肺表面活性剂治疗早产儿呼吸窘迫综合征的疗效观察

Clinical observation on domestic pulmonary surfactant in treatment of neonatal respiratory distress syndrome in preterm infants

目的探讨国产牛肺表面活性剂(珂立苏)治疗早产儿呼吸窘迫综合征(NRDS)的临床疗效及安全性。方法将85例患新生儿呼吸窘迫综合征的早产儿分为对照组38例及治疗组47例,对照组给予鼻塞持续气道正压通气,治疗组给予鼻塞持续气道正压通气与珂立苏联合应用,比较两组的临床疗效。结果治疗组患儿总有效率为85.11%,明显高于对照组的65.79%,二者差异有统计学意义(P<0.05)。治疗后2小时两组患儿血气指标较治疗前均明显好转(P<0.01),但治疗组患儿改善更明显(P<0.01)。治疗组患儿临床症状缓解和机械通气时间较对照组缩短,差异有统计学意义(P<0.05)。治疗组患儿肺部急慢性并发症发生率为23.40%(11/47例),明显低于对照组的44.74%(17/38例,P<0.05)。结论国产牛肺表面活性剂治疗早产儿呼吸窘迫综合征安全有效,联合鼻塞持续气道正压通气可显著提高临床疗效,改善血气指标,缓解临床症状和缩短机械通气时间,值得临床推广应用。

Objective To investigate the clinical effect and safety of domestic pulmonary surfactant （PS） in treatment of neonatal respiratory distress syndrome （NRDS） in preterm infants.Methods Eighty five preterm infants with NRDS were divided into treatment and control groups,nasal continuous positive airway pressure （NCPAP） was used in control group thirty-eight infants.NCPAP combined with domestic PS were used in treatment group forty-seven infants,clinical curative effect of the two groups were compared.Results The total effective rate of the treatment group was 85.11%,which was significantly higher than that of control group （65.79 %）,and the difference was significant （P〈0.05）.After two hours with the therapies,the blood gas analysis indexes of both groups were significantly improved when compared with those before the treatments （P〈0.01）,but those of the treatment group were improved more significantly （P 〈0.01）.The time of clinical symptom relief and mechanical ventilation in the treatment group was shorter than that of the control group （P〈0.05）.The incidence of acute and chronical pulmonary complication was lower than that of control group （23.40% vs 44.74%,P〈0.05）.Conclusion Domestic PS was safe and effective in treatment NRDS in preterm infants,PS combined with NCPAP in treatment of NRDS significantly elevates the clinical therapeutic effects,improves blood gas indexes,shortens the time of clinical smptom relief and mechanical ventilation and reduces the incidence of complications.