肺表面活性物质在早产儿RDS的预防性与治疗性用药比较分析  

Analysis of Pulmonary Surfactant Prophylactic Versus Therapic Dosage in Neonatal Respiratory Distresss Symdrome.

作　　者：陈健平[1] 黄献文[1] 彭江峰[1] 杨彤[1] 林希平[1] 

机构地区：[1]广西柳州市人民医院儿科,545001

出　　处：《医学研究杂志》2009年第2期83-85,96,共4页Journal of Medical Research

摘　　要：目的探讨预防性与治疗性使用肺表面活性物质(PS)在早产儿呼吸窘迫综合征(RDS)中的临床效果。方法选取39例胎龄在28～34周的早产儿,分为预防组17例,治疗组22例,比较两组使用PS前后血气指标、需机械通气患儿的呼吸机相关参数、主要并发症及预后。结果预防组使用PS前后的血气指标改善明显优于治疗组,治疗组需上机比例几乎2倍高于预防组(68.2%vs 35.3%),预防组在呼吸机PIP、MAP、FiO2的参数水平低于治疗组,上机时间及氧疗时间亦短于治疗组(以上比较P均<0.05)。预防组在重度(Ⅲ～Ⅳ级)HMD发生率、脑室内出血、肺出血以及病死率上均低于治疗组(P<0.05),而在慢性肺疾病(CLD)、早产儿视网膜病变(ROP)和气胸上无差异(P>0.05)。结论预防性使用PS可减少机械通气的使用,降低呼吸机应用参数,减少合并症的发生,能改善早产儿的预后和提高生存质量。Objective To evaluate the effectiveness of pulmonary surfactant prophylactic versus therapic dosage in neonatal respiratory distresss symdrome（NRDS）. Methods 39 prematures were divided into prophylactic group（ 17 cases） and therapic group（22 cases）. The gestational age were 28 to 34 weeks. The changes of blood gas, mechanical ventilation parameters, complication and prognosis were comporred. Results The changes of blood gas in prophylactic group were better than that in therapic group after using PS. As for the ratio of cases of requiring mechanical ventilation, therapic group were twice than prophylactic group （68.2% vs 35.3% ）. As for mechanical ventilation parameters, such as PIP, MAP, FiO2 ,the time of mechanical ventilation and the time of oxygen therapy,prophylactic group was less than therapic group. Prophylactic group was less than therapic group in the occurernce of Ⅲ- Ⅳ grade of hyaline membrane dis- ease（ HMD）,intraventricular hemorrhage, pneumorrhagia and mortality. Significant differences were found respectively （P 〈 0.05 ）. But there were no significant differences in the occurernce of chronic lung disease, retinopathy of prematurity and pneumothorax（ P 〉 0. 05 ）. Conclusion Pulmonary surfactant prophylactic therapy could decrease the use of mechanical ventilation, and the mechanical ventilation parameters,and declreasc the occurernce of complication. It could improve the prognosis and subsistence in prematures.

关 键 词：肺表面活性物质 早产儿 呼吸窘迫综合征 预防性用药 

分 类 号：R774.1[医药卫生—眼科] R722.12[医药卫生—临床医学]