新生儿呼吸窘迫综合征的挽救性治疗策略  

Rescue Treatment of Neonatal Respiratory Distress Syndrome

作　　者：王君[1] 周忠蜀[1] 陈飒英[1] 蓬蕊[1] 

机构地区：[1]中日友好医院儿科,北京100029

出　　处：《实用儿科临床杂志》2011年第2期125-127,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的通过回顾性总结分析本院新生儿呼吸窘迫综合征(NRDS)的救治情况,探讨肺表面活性物质(PS)挽救性治疗策略的疗效。方法回顾性分析46例NRDS患儿的临床资料。男33例,女13例;年龄40min～6h;胎龄32+5周;出生体质量(2022±779)g。按照是否应用PS分为2组:使用PS组(n=32)与未使用PS组(n=14)。比较2组呼吸支持时间和吸入吸氧体积分数(FiO2)、氧疗时间、住院天数、治愈率、病死率、并发症等情况。结果使用PS组和未使用PS组患儿的呼吸支持时间[17.5h(0～120.0h)vs0.5h(0.5～24.0h),P<0.05]、FiO2[32.5%(22%～90%)vs85.0%(40%～100%),P<0.05]比较有统计学差异。而2组氧疗时间[24h(2～240h)vs48h(2～408h),P>0.05]比较未见统计学差异。但与使用PS组比较,住院天数明显缩短。2组患儿并发症发生情况无明显差异。使用PS组患儿的治愈率为81.3%、病死率为18.8%,未使用PS组NRDS患儿的治愈率为35.7%、病死率为64.3%,2组治愈率比较差异有统计学意义(P<0.05)。结论挽救性应用PS可以显著提高NRDS的治愈率,降低病死率。Objective To investigate the efficacy and safety of rescued pulmonary surfactant（PS）treatment of neonatal respiratory distress syndrome（NRDS）.Methods A retrospective analysis was performed on 46 patients with NRDS.Among the 46 NRDS patients,there were 33 male and 13 female;the average weight was（2 022±779）g and the average gestation was 32＋5 weeks.The patients were categorized into 2 groups for analysis：PS group（n=32）,in which patients received PS replacement therapy;and no PS group（n=14）,in which patients were never administered of PS.For the cured infants of the 2 groups and the infants who died,the hours of oxygen therapy,duration of mecha-nical ventilation,hospital stay and complications were compared.Results The 2 groups with and without PS treatment had shown obvious difference in mechanical ventilation time [17.5 h（0-120.0 h）vs 0.5 h（0.5-24.0 h）,P0.05] and oxygen density breathed [32.5%（22%-90%）vs 85.0%（40%-100%）,P0.05].The 2 groups had shown no statistical difference in oxygen therapy time [24 h（2-240 h）vs 48 h（1-408 h）,P0.05].Compared with the PS group,the mortality rate in the no PS group was higher and hospital stay was obviously shorter.In the PS group（n=32）,cure rate was 81.3%,and mortality rate was 18.8%.In the no PS group（n=14）,the cure rate of RDS infants was 35.7%,and mortality rate was 64.3%.Compared with the no PS group,the PS group had demonstrated obvious increase in cure rate（P0.05）.Conclusion The application of rescue surfactant treatment is capable of obviousy increasing the cure rate and decreasing the mortality rate of the NRDS infants.

关 键 词：呼吸窘迫综合征 肺表面活性物质 治疗 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]