不同剂量肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效

The Application of Different Dose of Pulmonary Surfactant on the Treatment of Neonatal Respiratory Distress Syndrome

目的:探讨不同剂量肺表面活性物质(Pulmonary surfactant,PS)在气泡式鼻塞持续正压通气(Bubble nasal continuous positive airways pressure,BNCPAP)治疗新生儿呼吸窘迫综合征(Neonatal respiratory distress syndrome,NRDS)中的疗效。方法:将80例NRDS新生儿按数字随机法分为A组、B组、C组和对照组,每组20例。对照组采用气泡式鼻塞持续正压通气常规治疗,A组、B组和C组在对照组的基础治疗上经气管插管分别应用PS 40mg/kg、70mg/kg和100mg/kg。比较四组患儿治疗前、后的血气分析结果差异和不良反应、并发症的发生情况。结果:四组患儿治疗的有效率、治疗后血气分析和不良反应、并发症发生情况比较差异有统计学意义(P<0.05)。A、B、C三组患儿治疗有效率、血气分析改善和不良反应、并发症发生率均高于对照组;A、B、C三组患儿治疗后血气分析结果也存在差异(P<0.05)。C组患儿治疗有效率较A组提高,B组和C组患儿血气分析均较A组改善,但B组和C组患儿的不良反应和并发症发生率均高于A组;随着治疗用药浓度的增加,PS的治疗效果增加,差异有统计学意义(P<0.05)。结论:PS联合BNCPAP治疗NRDS效果良好,随着PS使用剂量的增加,患儿的疗效和血气分析改善效果更佳,且药效均持续72h仍有效,值得临床推广使用。

Objective :To investigate the effect of different dose of pulmonary surfactant (PS) and bubble nasal contin-uous positive airways pressure (BNCPAP) in the treatment of Neonatal Respiratory Distress Syndrome (NRDS) . Methods :80 cases of NRDS were enrolled ,randomized to group A ,B ,C and control group ,20 cases in each group .The control group was treated with regular treatment .Besides of the treatment of control group ,group A ,B ,C were treated with PS in 40mg/kg ,70mg/kg and 100mg/kg respectively .The curative effect ,blood gas analysis ,adverse reaction and complication occurrence of the 4 groups were compared .Results:There were differences in the curative effect ,blood gas analysis ,adverse reaction and complication occurrence in the 4 groups(P<0 .05) .The curative effect and blood gas a-nalysis results of group A ,B ,C were better than that of control group while the occurrence of adverse reaction and com-plications were higher than that of control group (P<0 .05) .The occurrences of adverse reaction and complication of group B and C were higher than that of group A while the blood gas analysis was better than that of group A (P<0.05) .The curative effect of group C was higher than that of group A (P<0 .05) .The curative effect increased with the increase of PS dose(P<0 .05) .Conclusion:The treatment of PS and BNCPAP in NRDS was effective and the phar-macodynamic action lasted to the 72th hours .The curative effect was connected with PS dose .The effect of treatment of PS and BNCPAP in NRDS was better when the dose of PS increased gradually .