雾化吸入肺表面活性物质治疗新生儿呼吸窘迫综合征的临床研究  

The clinical study of treatment effects of inhalation of pulmonary surfactant on Neonatal Respiratory Distress Syndrome

作　　者：郭继忠[1] 卢燕君[1] 冯欣蘅[2] 房晓祎[1] 林霓阳[1] 

机构地区：[1]汕头大学医学院第一附属医院儿科,广东汕头515041 [2]汕头大学医学院第二附属医院急诊科

出　　处：《中国妇幼保健》2007年第34期4827-4829,共3页Maternal and Child Health Care of China

基　　金：2004年度汕头市重点科技计划项目

摘　　要：目的:观察雾化吸入肺表面活性物质(Pulmonary surfactant,PS)治疗新生儿呼吸窘迫综合征(Neonatal respir-atory distress syndrome,NRDS)的临床效果。方法:44例NRDS患儿分为3组,分别雾化吸入PS(雾化组)16例,用气道内滴入PS(气内组)16例以及单纯应用呼吸机治疗(单纯组)12例。观察3组患儿不同方法治疗后的临床症状,动脉血气分析,上机时间以及并发症情况。结果:雾化组中,治疗后仅3例需要机械通气,上机时间0～52h,平均上机时间(45.3±8.33)h,治疗后动脉血气(PH、PO2、PCO2、a/APO2)结果均有改善,显效12例,有效4例,并发肺部感染2例;气内组中有9例需机械通气,平均上机时间(76±8)h,显效13例,有效3例,并发肺部感染10例,肺不张2例;单纯组12例中,均需应用呼吸机辅助通气,平均上机时间(105±15)h,显效6例,有效5例,无效1例,并发肺部感染11例,气胸1例,肺不张2例。结论:雾化吸入PS能在较短时间有效改善肺换气和弥散功能,促进氧合,改善临床症状,减少并发症,减少上呼吸机时间。Objective： To study the clinical effects of inhalation of pulmonary surfactant （PS） on Neonatal Respiratory Distress Syndrome （NRDS） . Methods： The 44 cases of NRDS were divided randomly into 3 groups： 16 cases were in PS inhalation group who were treated using inhalation of PS, 16 cases were in intra - airway using PS group who were treated through dropping PS into the respiratory tract and other 12 cases were in ventilator group who were treated with ventilator and without PS. To observe the clinical symptoms, the results of arterial blood gas （ABG） , the durations of using ventilator and the incidences of complications among there groups. Results： In the PS inhalation group, 3 cases needed ventilator after treatment. The average times of using ventilator were 45.3 ±8. 33 h. The clinical symptoms and the results of ABG were all improved. 12 cases had excellent effects and 4 cases had good effects. In the intra - airway using PS group, 9 cases needed ventilator after treatment. The average times of using ventilator were 76 ± 8 h. 13 cases had excellent effects and 3 cases had good effects. 10 cases complicated with pneumonia and 2 cases had pulmonary atelectasis. In ventilator group, the average times of using ventilator were 105 ± 15h. 6 cases had excellent effects, 5 cases had good effects and 1 case had no effects. 11 cases had pneumonia, 1 case had pneumothorax and 2 cases complicated with pulmonary atelectasis. Condusion： Inhalation of PS can improve the pulmonary ventilation and diffusion fimction in a short time （within 1 hour） and promote oxygenation so as to improve the clinical symptoms and decrease the incidences of complications and the durations of using ventilator.

关 键 词：肺表面活性物质 早产儿 雾化吸入 新生儿 呼吸窘迫综合征 

分 类 号：R722[医药卫生—儿科]