不同肺表面活性物质治疗新生儿呼吸窘迫综合征的临床效果对比

Comparison of clinical efficacy between different pulmonary surfactants for treatment of neonatal respiratory distress syndrome

目的比较不同肺表面活性物质治疗新生儿呼吸窘迫综合征的临床效果。方法选择新生儿呼吸窘迫综合征患儿77例,随机分为观察组39例和对照组38例,两组均给予常规治疗,同时对照组给予牛肺表面活性剂,观察组给予猪肺磷脂注射液治疗,观察两组患儿在治疗前及治疗后第2周机械通气参数、治疗后第2周疗效总有效率、并发症发生情况、住院总费用以及住院时间。结果经过治疗,观察组的呼气末正压通气、吸气峰压、吸氧浓度均较前下降,且均低于对照组(P<0.05)。观察组的治疗总有效率为89.74%,高于对照组的76.31%(P<0.05)。观察组并发症总发生率为38.46%,对照组为44.73%,两组比较差异无统计学意义(P>0.05)。观察组的住院总费用少于对照组,住院时间短于对照组(P<0.05)。结论对于新生儿呼吸窘迫综合征患儿,采用猪肺磷脂注射液治疗的效果优于牛肺表面活性剂,其能明显降低患儿的机械通气参数、缩短住院时间、减少住院开支。

Objective To compare the clinical efficacy between different pulmonary surfactants for the treatment of neonatal respiratory distress syndrome（ NRDS）. Methods Seventy-seven newborns with NRDS were randomly divided into observation group（ n = 39） and control group（ n = 38）. The routine therapy was conducted in both groups. At the same time,bovine lung surfactant and poractant alfa injection were administered in the control group and the observation group respectively. The mechanical ventilation parameters before treatment and in the 2nd week after treatment,the total effective rate in the 2nd week after treatment,the incidence of complications,the total cost of hospitalization,and hospital stay were compared between the two groups. Results After treatment,all positive end-expiratory pressure（ PEEP）,peak inspiratory pressure（ PIP） and fraction of inspirationO2（ FiO2） in the observation group decreased and were lower than those in the control group（ P〈0. 05）. The total effective rate of the observation group was 89. 74%,and was higher than that of the control group（ 76. 31%; P〈0. 05）. The total incidence rate of complications in the observation group was 38. 46%,and in the control group was 44. 73%,but no statistical difference was observed between two groups（ P〉0. 05）. The total cost of hospitalization and hospital stay in the observation group were less than those in the control group（ P〈0. 05）. Conclusion For newborns with NDRS,the efficacy of poractant alfa injection is superior to that of bovine lung surfactant. Poractant alfa injection can significantly decrease the mechanical ventilation parameters of the newborns,shorten hospital stay and reduce hospital cost.