珂立苏治疗晚期早产儿RDS的最佳剂量研究

Optimal dosage of Calsurf for treatment of late preterm infants with respiratory distress syndrome

目的探讨珂立苏(PS)治疗晚期早产儿呼吸窘迫综合征(RDS)的最佳剂量。方法选择于2006年1月至2014年9月在内江市东兴区人民医院就诊的晚期早产儿RDS患儿60例,将60名患儿随机分为观察组(n=30)和对照组(n=30);观察组应用PS 70mg/kg进行治疗,对照组应用PS 40mg/kg进行治疗,比较两组血气指标、氧合指数、并发症发生情况等,分析对比两组患者的治疗效果。结果第1次给药24小时后,可见氧合指数(OI)和二氧化碳分压(PCO2)均有明显降低,氧分压(PO2)水平有明显升高。治疗后观察组OI和PCO2水平明显优于对照组,差异均有统计学意义(t值分别为-6.505、-3.093,P<0.05);治疗后PO2水平两组差异无统计学意义(均P>0.05)。观察组机械通气时间[经鼻持续气道正压通气(n CPAP)、同步间歇指令通气(SIMV)](t值分别为-5.188、-4.132)、应用PS次数(t=-4.038)、肺炎发生率(χ2=9.320)、氧疗时间(t=-7.006)和住院时间(t=-3.027)均低于对照组,差异均有统计学意义(均P<0.05)。两组患儿的治愈率差异无统计学意义(P>0.05)。结论 PS治疗晚期早产儿RDS患者时,最佳剂量为70mg/kg。

Objective To analyze the optimal dosage of Calsurf （ PS） for treatment of late preterm infants with respiratory distress syndrome （ RDS） .Methods Altogether 60 late preterm infants with RDS who were treated in Dongxing District People ’ s Hospital in Neijiang City from January 2006 to September 2014 were selected and randomly divided into control group （30 cases） and observation group （30 cases）. The infants in the observation group were given 70mg/kg of PS, and the infants in control group were given 40mg/kg of PS.Blood gas indicators , oxygenation index （ OI） and incidence of complications were compared between two groups to analyze the treatment effect of two groups.Results After 24 hours of the first administration , OI and partial pressure of carbon dioxide （ PCO2 ） were significantly reduced , and partial pressure of oxygen （PO2） level increased significantly.After treatment, the levels of OI and PCO2 of the observation group were significantly better than those of the control group , and the differences were statistically significant （ t value was -6.505 and -3.093, respectively, both P 〈0.05）.There was no significant difference between two groups in level of PO 2 （both P 〉0.05）.Mechanical ventilation time [ nasal continuous positive airway pressure （ nCPAP ） and synchronized intermittent mandatory ventilation （ SIMV ） ] （ t value was -5.188 and -4.132, respectively）, the number of PS application （t=-4.038）, incidence of pneumonia （χ2 =9.320）, oxygen therapy time （t=-7.006） and hospitalization time （t=-3.027） of the observation group were lower than those of the control group, and the differences were statistically significant （all P 〈0.05）.Difference in cure rate between two groups had no statistical significance （P〉0.05）.Conclusion Optimal dosage of PS for treatment of late preterm infants with RDS is 70mg/kg.