肺表面活性物质不同用药方案治疗对新生儿呼吸窘迫综合征临床对比分析

Clinical comparative analysis of pulmonary surfactant different treatment regimens for neonatal respiratory distress syndrome

目的探讨肺表面活性物质不同用药方案治疗对新生儿呼吸窘迫综合征临床效果,以期提高疗效。方法选取2011年12月-2013年12月72例新生儿呼吸窘迫综合征患者为研究对象,分成两组,均采用牛肺表面活性物质治疗,剂量分别采用50mg/kg(对照组)、100mg/kg(研究组),观察治疗后在疗效、血气分析和并发症等方面情况差异。结果对照组胸片Ⅰ级占75%、Ⅱ级占13.89%、Ⅲ级占11.11%,研究组胸片Ⅰ级占88.88%、Ⅱ级占2.78%、Ⅲ级占2.78%,两组比较差异显著(P<0.05);两组治疗后Pa O2、PH较治疗前均显著升高,Pa CO2显著下降,前后比较差异显著(P<0.05),研究组治疗后在以上指标上较对照组治疗后改善更加显著(P<0.05);研究组在机械通气时间、用氧时间、住院时间较对照组明显缩短,两组比较差异显著(P<0.05);在肺气漏、颅内出血、呼吸机相关肺炎、支气管肺发育不良、早产儿视网膜病并发症发生率上比较无差异性(P>0.05)。结论肺表面活性物质治疗新生儿呼吸窘迫综合征临床效果显著,且剂量和疗效正相关。

Objective To investigate the pulmonary surfactant treatment regimens for different clinical effect of neonatal respiratory distress syndrome, in order to improve the outcome. Methods 72 cases of neonatal respirato- ry distress syndrome from December 2011 to December 2013 were randomly divided into two groups. All of them were given bovine lung surfactant therapy, and the dose of the control group was 50mg/kg, and 100mg/kg of the study group. The differences in efficacy, blood gas analysis and complications were observed after treatment. Results There were 75% of chest Class Ⅰ, 13.89% of Class Ⅱ, and 11.11% of Class Ⅲ in the control group, and 88. 88% of Class Ⅰ, 2. 78% of Class 11 and 2.78% of Class Ⅲ in the study group, respectively （P 〈 0. 05）. After treatment, the value of PaO2 and PH increased obviously, and the level of PaCO2 decreased clearly in the two groups, and the difference was more pronounced in the study group than in the control group （P 〈 0.05 ）. The time of mechanical ventilation, oxygen supply, and hospital stay was significantly shorter in the study group than in the control group （P 〈 0. 05）. There was no significant difference in pulmonary air leak , intracranial hemorrhage, ventilator-associated pneumonia and bronchopulmonary dysplasia between the two groups （P 〉 0. 05）. Conclusion Pulmonary surfactant treatment has significant curative effect for neonatal respiratory distress syndrome, and the curative effect is positively correlated with the dose.