肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效观察

Observation of the Pulmonary Surfactant Therapy for Neonatal Respiratory Distress Syndrome

目的:观察肺表面活性物质治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法:选取2013年5月至2014年11月我院收治的57例NRDS患儿,随机分为治疗组32例和观察组25例,治疗组使用肺表面活性物质(珂立苏)联合鼻塞持续气道正压呼吸治疗,观察组使用机械通气治疗,观察两组患儿治疗效果及临床特征。结果:两组治疗前血气分析及呼吸机参数比较差异无统计学意义(P>0.05)。治疗后2 h治疗组Pa O2为(65.09±5.52),观察组为(58.56±5.23);OI治疗组为(5.83±1.96),观察组(6.13±1.15);a/A PO2治疗组(0.361±0.092),观察组(0.163±0.062)。呼吸机参数在治疗后Fi O2治疗组为(0.34±0.09),观察组为(0.44±0.14);PEEP治疗组为(4.09±1.16),观察组为(4.28±1.11)。治疗组患儿治疗后肺氧合功能比观察组改善程度更为显著,两组比较差异有统计学意义(P<0.05)。两组治疗前及治疗48 h后X线胸片结果显示治疗组复查24例,有18例恢复正常,6例好转;对照组复查19例,5例恢复正常,10例好转,4例无改变。治疗组临床治愈率为81.25%,对照组为60.00%。结论:肺表面活性物质治疗NRDS能迅速有效的改善肺部氧合功能和肺通气,使用方便,治疗效果值得肯定。

Objective： To observe the effect of pulmonary surfactant（ PS） therapy for neonatal respiratory distress syndrome（ NRDS）.Methods： Fifty seven neonates with NRDS were divided into a treatment group（ n = 32） and an observation group（ n = 25）. The two groups were treated with the same routine drugs and ventilator therapy,while PS combined with nasal continuous positive airway pressure（ n CPAP） were added to the observation group. The therapeutic effects and clinical features of the two groups were observed. Results：Before the treatment,there was no obvious difference in the parameter of blood-gas analysis between two groups（ P〉0.05）. After 2 hours treatment,the parameter of Pa O2 in treatment group was（ 65. 09 ± 5. 52）,and in observation group was（ 58. 56 ± 5. 23）,OI in the treatment group was（ 5.83±1.96）,and in observation group was（ 6.13±1.15）,a / A PO2 in the treatment group was（ 0.361±0. 092）,and in observation group was（ 0.163±0.062）. After the treatment,the parameter of breathing machine showed that Fi O2 in the treatment group was（ 0.34±0.09）,and in the observation group was（ 0. 44 ± 0. 14）,PEEP in the treatment group was（ 4. 09 ± 1. 16）,and in observation group was（ 4.28±1.11）. After treatment the oxygenation function of the treatment group compared with the observation group improved more significantly,with a significant difference between two groups（ P〈0.05）. Before and 48 hours after treatment,the X-ray chest pieces of two groups improved and existed difference obviously. Through reviewing the 24 patients of the treatment group,it showed that 18 patients recovered from the cure,and 6 patients improved. From the reviewing of 19 patients of the observation group,it got a result that 5 patients’ conditions return to normal,10 patients got better,and 4 patients had no any changes. The cure rate of treatment group was 81.25% and observation group was 60.00%. Conclusion： The application of calf pulmonary surfactant for injection combined with n CPAP in the treatment of NRDS has good effects and raises the rescue success rate significantly.