不同剂量牛肺表面活性物质治疗新生儿呼吸窘迫综合症疗效分析

Different doses of cattle lung surface active substance treatment efficacy analysis of neonatal respiratory distress syndrome

目的评价不同剂量牛肺表面活性物质(PS)治疗新生儿呼吸窘迫综合症(NRDS)临床疗效,总结治疗经验。方法大剂量组患者21例以100 mg/kg(体重)标准给药,小剂量组患者35例以40 mg/kg标准给药,统计对比相关指标。结果初次用药后60 min,两组Pa O2高于治疗前、Pa CO2低于治疗后,大剂量组Pa O2达(89.3±11.7)mm Hg高于小剂量组(80.2±11.2)mm Hg、Pa CO2达(44.0±6.4)mm Hg低于大剂量组(49.0±8.2)mm Hg,大剂量组用药例次率104.76%、并发症例次率38.10%低于小剂量组208.82%、47.06%,大剂量组呼吸支持时间(5.2±1.4)d、氧疗时间(8.2±3.0)d、住院时间(25.3±5.3)d低于小剂量组(8.8±1.9)d、(14.0±3.1)d、(35.8±4.1)d,差异具有统计学意义(P<0.05)。结论大剂量运用PS治疗NRDS虽可增加并发肺部炎症风险,但收效更高,有助于患儿呼吸功能恢复,进而缩短疗程,降低机械通气相关并发症发生几率、缩短住院时间,改善患儿结局。

Objective： To evaluate the different dose of lung surface active substances（ PS） treatment of neonatal respiratory distress syndrome（ NRDS） clinical curative effect,summary treatment experience. Methods： 21 patients with large dose group with 100 mg / kg（ weight） standard dosing,small dose group of 35 patients with 40 mg / kg standard dosing,statistical contrast relevant indicators. Results： 60 min after first use,two groups of Pa O2 higher than before,Pa CO2 below after treatment,Pa O2 of high- dose group（ 89. 3 ＋ 11. 7） mm Hg higher than low- dose group（ 80. 2 ＋ 11. 2）mm Hg,Pa CO2（ 44. 0 ＋ 6. 4） mm Hg lower than that of high- dose group（ 49. 0 ＋ 8. 2） mm Hg,high- dose group of drug cases rate,complication rate of 38. 10% 104. 76% lower than the low- dose group were 208. 82%,47. 06%,large dose group of respiratory support time（ 5. 2 ＋ 1. 4） d,oxygen cure time,length of hospital stay（ 8. 2 ＋ 3. 0） d（ 25. 3＋ 5. 3） d is lower than the low- dose group（ 8. 8 ＋ 1. 9）,（ 14. 0- 3. 1） d,d（ 35. 8 ＋ 4. 1） d,statistically significant difference（ P〈 0. 05）. Conclusion： high dose use PS although treatment of NRDS can increase the risk of concurrent lung inflammation,but it is higher,help children with respiratory function recovery,and shorten the period of treatment,reduce the mechanical ventilation related complications rate,shorten hospitalization time,children improve outcomes.