新生儿呼吸窘迫综合征肺表面活性物质治疗后肺氧合功能和尿量变化的观察

Changes of urine output in newborns with respiratory distress syndrome treated with pulmonary surfactant

目的 探讨新生儿呼吸窘迫综合征 (RDS)予肺表面活性物质 (PS)治疗后的尿量变化及尿量与肺氧合功能的关系。方法 对新生儿重症监护病房 (NICU)行呼吸机治疗的 2 0例RDS患儿予血气监测及每小时尿量和入量监测。结果 观察组 (PS组 )最大尿量峰值出现于生后 6 0h ,与对照组比较有显著性差异 (P <0 0 5 )。尿量 /入量比值PS组于生后 48h即大于 0 8,而对照组的上述比值大于 0 8出现于生后 6 0h。尿量与动脉 /肺泡氧分压比值 (PaO2 /PAO2 )有显著相关性 (r =0 7414,P <0 0 5 )。结论 RDS病程中随着尿量增加肺氧合功能改善 ,予PS治疗后利尿期最大尿量峰值增大 ,出现时间早 ,提示在PS治疗后更应该密切观察尿量变化 ,判断病情的恢复。

Objective To study the changes of urine output and its relationship with oxygenation in newborns with respiratory distress syndrome(RDS)treated with pulmonary surfactant(PS).Methods\ 20 cases of RDS treated with ventilator in neonatal intensive care unit (NICU) were detected for arterial blood gas and for urine output and fluid intake for each hour.Results\ The peak of urine output in the group treated with PS (group PS) occurred at 60 hours of life and the level was higher than that in control group(P<0 05).The ratio between the urine output and fluid intake was more than 80%,which began at 48 hours of life in group PS,but that in control group began at 60 hours of life.There was a significant correlation between the urine output and PaO 2 /P AO 2 (r=0 7414,P<0 05).Conclusion\ The pulmonary oxygenation is improved with the increasing of the urine output in the illness course.The peak of urine output in diuretic phase is high and the onset is early.The changes of urine output are important to determine the resumption of RDS treated with PS.