不同时间给予肺表面活性物质治疗对呼吸窘迫综合征早产儿的影响  

Effect of early versus delayed pulmonary surfactant treatment of respiratory distress syndrome in premature infants

作　　者：康文清[1] 孙慧清[1] 陈宇辉[1] 郭静[1] 李明超[1] 许邦礼[1] 周炎娟[1] 熊虹[1] 

机构地区：[1]郑州市儿童医院新生儿科,450053

出　　处：《中国新生儿科杂志》2012年第1期32-35,共4页Chinese Journal of Neonatology

摘　　要：目的探讨早期或晚期给予肺表面活性物质(PS)治疗对呼吸窘迫综合征(RDS)早产儿的影响。方法本院新生儿科2009—2010年收治的RDS早产儿,按照PS的给予时间分为早期组(出生2 h内给药)和晚期组(出生2～12 h给药),比较两组机械通气时间、氧疗时间、病死率以及并发症发生率方面的差异。结果早期组48例,晚期组51例,早期给予PS能显著减少机械通气时间和氧疗时间[机械通气时间:(4.1±1.9)天比(5.4±2.2)天,氧疗时间:(5.8±3.4)天比(8.1±5.5)天,P<0.05]。但未影响气漏、肺出血、动脉导管未闭、坏死性小肠结肠炎、严重脑室内出血和支气管肺发育不良的发生率以及RDS早产儿的病死率。结论早期给予PS治疗能显著减少RDS早产儿的机械通气时间和氧疗时间。Objective To evaluate the effect of early versus delayed pulmonary surfactant （PS） usage in treatment of neonatal Respiratory Distress Syndrome （RDS）. Methods 99 preterm infants with RDS admitted to our NICU from 2009 -2010 were recruited for this study. Patients were assigned into two groups： early treatment group of 48 patients vs. late treatment group of 51 patients based on the timing of surfactant administration （ 〈2 hr vs. 2- 12 hr post delivery）. Differences in the duration of mechanical ventilation ＆ oxygen therapy, as well as the morbidity ＆ mortality rates were compared. Results Early surfactant administration significantly decreased the duration of mechanical ventilation [（4.1 ±1.9）dvs. （5.4±2.2）d, P〈0.05] and oxygen therapy [（5.8±3.4）dvs. （8.1 ±5.5）d, P 〈 0.05 ） ]. There were no statistical difference for the incidence of pnemothorax, pulmonary hemorrhage, patent ductus arteriosus, necrotizing enterocolitis, severe intraventricular hemorrhage and bronchopulmonary dysplasia between the two groups. The infant mortality rates were also similar in both groups. Conclusions Early surfactant usage in premature infants with RDS can significantly decrease the duration of mechanical ventilation and oxygen therapy.

关 键 词：肺表面活性物质 呼吸窘迫综合征 新生儿 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]