珂立苏治疗早产儿肺透明膜病与支气管肺发育不良的关系

Effect of calsurf on the incidence of bronchopulmonary dysplasia

目的探讨不同时间段珂立苏治疗早产儿肺透明膜病(HMD)与发生支气管肺发育不良(BPD)的关系。方法将胎龄<37周并出现生后进行性呼吸困难且胸片提示HMD的100例早产儿,根据珂立苏使用时间分4组进行临床对照研究:<6 h组(A组,n=25),≥6 h且<12 h组(B组,n=25),≥12 h且<24 h组(C组,n=25),未用药组(D组,n=25),比较4组间总氧疗时间、机械通气时间、再次插管机械通气率、住院时间和支气管肺发育不良发生情况。结果 A组与D组的通气时间、总氧疗时间、住院时间比较,差别有统计学意义(P<0.05);A组与C组的总氧疗时间、住院时间比较,差别有统计学意义(P<0.05);A组与B组的总氧疗时间比较,差别有统计学意义(P<0.05);A组与C组、A组与D组的再次插管机械通气率比较,差别有统计学意义(P<0.05);B组与D组的再次插管机械通气率比较,差别有统计学意义(P<0.05);A组与C组、B组与D组的BPD发病率比较,差别有统计学意义(P<0.05);A组与D组的BPD发病率比较,差别有统计学意义(P<0.05)。结论珂立苏治疗早产儿肺透明膜病能够有效的缩短通气时间、总氧疗时间、住院时间,降低再次插管机械通气率,且越早使用效果越明显,并能预防BPD的发生。

Objective To explore the effect of different stages of using calsurf on the incidence of bronchopulmonary dysplasia. Methods Date were retrospectively collected from NICU ,one hundred premature infants with hyaline membrane disease were divided into 4 groups according to the stages of using calsurf:<6 hours group(A group,n =25),≥6 hours and <12 hours group(B group,n =25),≥12 hours and <24 hours group(C group,n =25 ),no-calsurf group(D group,n =25 ).The durations of oxygen therapy and mechanical venti-lation,frequency of repeated intubation,length of hospitalization and the incidence of BPD were compared among the four groups.Results Comparing the durations of oxygen therapy ,mechanical ventilation and length of hospitalization between A and D,there was significant differ-ence(P<0.05).Comparing the durations of oxygen therapy and length of hospitalization between A and C,there was significant difference(P<0.05).Comparing the durations of oxygen therapy between A and B,there was significant difference(P<0.05).Comparing frequency of repeated intubation between A and C,there was significant difference(P<0.05).Comparing frequency of repeated intubation between A and D,there was significant difference(P<0.05).Comparing frequency of repeated intubation between B and D,there was significant difference (P<0.05).Comparing the incidence of BPD between A and D,there was significant difference(P<0.05).Comparing the incidence of BPD between A and C,there was significant difference(P<0.05).Comparing the incidence of BPD between B and D,there was significant differ-ence(P<0.05 ).Conclusions Calsurf administration can reduce the durations of oxygen therapy and mechanical ventilation,frequency of repeated intubation,and prevent the development of BPD,especially in early stage.