国产牛肺表面活性物质在预防新生儿呼吸窘迫综合征作用的探讨

Effect of domestic bovine pulmonary surfactant on the prevention of neonatal respiratory distress syndrome

目的：研究国产牛肺表面活性物质对预防新生儿呼吸窘迫综合征的应用价值。方法将禹州市妇幼保健院94例早产儿随机分为观察组与对照组,每组47例,观察组新生儿出生6 h 后给予国产牛肺表面活性物质,对照组未应用。比较两组血气、氧合指标、呼吸窘迫综合征发生率、机械通气量率及病死率。结果观察组12、24 h PaO2分别为（80.2±11.6）、（88.6±9.1） mm Hg（1 mm Hg =0.133 kPa）,显著高于对照组（P 〈0.05）,而PaCO2则在12、24 h 时分别为（50.3±7.1）、（41.6±8.1）mm Hg,显著低于对照组（P 〈0.05）。观察组 pH 值仅在12 h 时显著高于对照组（P 〈0.05）。氧合指数0.5 h 时比较差异未见统计学意义（P 〉0.05）,后观察组显著高于对照组（P 〈0.05）。观察组呼吸窘迫、机械通气发生率均为6.4%,显著低于对照组的31.9%、21.3%。观察组病死率为2．1%,对照组为6.4%,差异未见统计学意义（P 〉0.05）。结论国产牛肺表面活性物质预防新生儿呼吸窘迫综合征的临床效果显著,同时可改善患儿临床症状,降低呼吸窘迫发生率,提高新生早产儿的存活率。

Objective To study the application value of domestic bovine pulmonary surfactant on the prevention of neonatal respiratory distress syndrome. Methods Ninety-four cases of premature infants were randomly divided into obser-vation group and control group, with 47 cases in each group. The newborn in the observation group were given the domestic bovine pulmonary surfactant 6 h after birth, the control group were not given. The blood gas, oxygenation index, the inci-dence of respiratory distress syndrome,the mechanical ventilation rate and fatality were compared between the two groups. Results In the observation group,PaO2 at 12, 24 h were （80. 2 ± 11. 6）, （88. 6 ± 9. 1）mm Hg respectively, which were significantly higher than that in the control group （P 〈 0. 05）, and PaCO2 at 12 and 24 h were （50. 3 ± 7. 1）, （41. 6 ± 8. 1） mm Hg respectively,which were significantly lower than those in the control group （P 〈 0. 05）. The pH value of the observation group was significantly higher than that of control group only at 12 h（P 〈 0. 05）. The oxygen index of 0. 5 h had no significant difference （P 〉 0. 05）, after then that in the observation group was significantly higher than that in the control group （P 〈 0. 05）. The respiratory distress and mechanical ventilation occurred rate were 6. 4% , 6. 4% in the ob-servation group, which were significantly lower than those in the control group（31. 9% , 21. 3% ）. The fatality was 2. 1%in the observation group,and 6. 4% in the control group,there was no significant difference （P 〉 0. 05）. Conclusions The clinical effect of domestic bovine pulmonary surfactant on the prevention of neonatal respiratory distress syndrome is re-markable, at the same time it can improve the clinical symptoms, reduce the occurrence of respiratory distress rate and im-prove the survival rate of newborn infants.