比较不同剂量肺表面活性物质治疗新生儿呼吸窘迫综合征的临床效果

To Compare the Clinical Effect of Different Dosage of Lung Surface Active Substance on Neonatal Respiratory Distress Syndrome

目的研究不同剂量肺表面活性物质(PS)对新生儿呼吸窘迫综合征(NRDS)的治疗效果,从而寻求合理PS用药剂量。方法选取2014年11月至2016年12月确诊的74例NRDS患儿,随机分为研究组(37例)和对照组(37例)。对照组给予常规PS剂量(100 mg/kg),研究组给予大剂量PS治疗(200 mg/kg),比较两组吸入氧浓度(FiO_2)、氧合指数(OI)、平均气道压力(MAP)、呼气末正压(PEEP)、住院时间、机械通气时间、氧疗时间、住院费用及临床疗效。结果用药12 h后,两组FiO_2、OI、MAP、PEEP四项呼吸机参数均明显低于用药前,而研究组FiO_2、OI、MAP、PEEP四项指标均明显低于对照组,差异均具有统计学意义(P<0.05);研究组住院时间、氧疗时间、机械通气时间及住院费用均明显低于对照组,差异均有统计学意义(P<0.05);研究组治疗总有效率明显高于对照组,差异具有统计学意义(P<0.05)。结论早产儿NRDS使用大剂量PS(200 mg/kg)治疗能够显著改善症状体征,减少住院时间、氧疗时间、机械通气时间以及住院费用,提升临床治疗效果。

Objective To study the therapeutic effect of different doses of lung surface active substance（PS） on neonatal respiratory distress syndrome（NRDS）,thus seeking a reasonable dose of PS.Methods 74 cases of NRDS were selected from November 2014 to December 2016,randomly divided into the study group（37 cases） and the control group（37 cases）.Control group given conventional PS dose（100 mg/kg）,the team gave high doses of PS treatment（200 mg/kg）,compared two groups of inhaled oxygen concentration（FiO2）,oxygen index（OI）,mean airway pressure（MAP）,breathe out at the end of the positive pressure（PEEP）,length of hospital stay,mechanical ventilation time,oxygen cure time,hospitalization expenses and clinical curative effect.Results After 12 h,two groups of FiO2,OI,MAP,PEEP four drug breathing machine parameters were significantly lower than before,and the team FiO2,OI,MAP,PEEP four indicators were significantly lower than the control group,the differences were statistically significant（P〈0.05）;The hospitalization time,oxygen therapy time,mechanical ventilation time and hospitalization expenses of the study group were significantly lower than the control group,and the difference was statistically significant（P〈0.05）.The total effective rate was significantly higher than the control group,and the difference was statistically significant（P〈0.05）.Conclusion The premature NRDS using large dose of PS（200 mg/kg） treatment can significantly improve the symptoms and signs,reduce hospitalization time,oxygen cure time,mechanical ventilation time and hospitalization costs,improve the clinical therapeutic effect.