猪肺磷脂联合常规治疗对呼吸暂停早产儿的影响

Effects of poractant alfa combined with conventional therapy on premature infants with apnea

目的探讨猪肺磷脂联合常规治疗对呼吸暂停早产儿的治疗效果。方法选取2016年9月至2017年9月收治的96例呼吸暂停早产儿,随机分为对照组(48例)和观察组(48例)。两组患儿出现呼吸暂停症状时及时给予经鼻持续气道正压通气(NCPAP)治疗,并记录发生呼吸暂停的次数。对照组给予常规治疗,观察组在对照组的基础上注射猪肺磷脂治疗。比较两组患儿治疗后的肺功能及纠正胎龄40周时神经行为及智力、运动发育情况。结果观察组患儿治疗后出现呼吸暂停的次数及使用氧气、NCPAP治疗的时间均低于对照组,两组比较差异有统计学意义(P<0.05)。经过治疗,观察组患儿的肺功能参数均高于对照组,差异有统计学意义(P<0.05)。观察组患儿的神经行为评分高于对照组[(38.62±1.18)分vs(35.24±1.37)分],差异有统计学意义(P<0.05)。观察组的MDI、PDI评分均高于对照组,差异亦有统计学意义(P<0.05)。结论猪肺磷脂可改善早产儿早期肺功能,降低早产儿呼吸暂停的发生次数,对神经行为发育也有一定的促进作用。

Objective To investigate the effects of poractant alfa combined with conventional therapy on premature infants with apnea. Methods Ninety-six premature infants with apnea admitted to hospital from September 2016 to September 2017 were randomly divided into control group and observation group ( n = 48 , each). Nasal continuous positive airway pressure ( NCPAP) was given in both groups as soon as apnea symptoms appeared, and the frequency of apnea was recorded. The conventional treatment was performed in control group, and poractant alfa injection was added in observation group based on the treatment in control group. The pulmonary function after treatment and the neurobehavioral, intellectual and motor development at 40 weeks corrected age were compared between two groups. Results After treatment, the number of apneas and the time of treatment with oxygen and NCPAP decreased significantly in observation group compared with control group (all P < 0. 05),and the lung function parameters were statistically higher than those in control group (all P < 0. 05). The neurobehavioral score (38.62 ± 1. 18 vs 35. 24 ± 1. 37 ), mental development index ( MDI) and psychological development index ( PDI) in observation group were significantly higher than those in control group ( all P < 0. 05 ). Conclusion Poractant alfa can improve the pulmonary function of premature infants, reduce the incidence of apnea and have certain promotion effect on the development of neurobehavioral behavior.