不同剂量国产牛肺表面活性物质治疗早产儿呼吸窘迫综合征疗效观察  

Observation on the clinical curative effect of different doses of calf pulmonary surfactant in the treatment of premature infants with respiratory distress syndrome

作　　者：陈冶[1] 洪淑君 张艳丽[1] 陈爱斌[2] 潘家华[1] 陈名武[1] 

机构地区：[1]安徽医科大学附属安徽省立医,安徽合肥院230001 [2]皖南医学院附属弋矶山医院,安徽芜湖241001

出　　处：《临床肺科杂志》2015年第7期1255-1259,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的评价不同剂量国产牛肺表面活性物质治疗早产儿呼吸窘迫综合征临床疗效及安全性。方法采用国产牛肺表面活性物质三种剂量治疗早产儿呼吸窘迫综合征的患儿,其中符合入选标准研究对象共93例。随机分为小剂量组(40-70 mg/kg,31例)、中剂量组(70-100 mg/kg,31例)和大剂量组(100-140 mg/kg,31例),比较三组患儿用药前后血气分析(p H,Pa O2,Pa CO2)的变化情况,记录三组患儿的性别、胎龄、出生体重、分娩方式、Apgar评分、羊水情况、有无胎膜早破、需重复用药例数、需机械通气例数、需机械通气时间、氧疗时间、住院天数、转归、并发症及平均住院费用等,进行统计分析。结果三组患儿比较性别、胎龄、出生体重、分娩方式、Apgar评分、羊水情况、有无胎膜早破等差异均无统计学意义(P>0.05)。三组患儿首次应用肺表面活性物质治疗6 h后p H值及Pa O2均有不同程度升高、Pa CO2均有不同程度降低,与治疗前比较差异均有统计学意义(P<0.05)。治疗前三组之间p H值、Pa O2及Pa CO2差异均无统计学意义(P>0.05)。三组患儿之间比较治疗效果(需重复用药例数、需机械通气例数、需机械通气时间、氧疗时间)的差异均无统计学意义(P>0.05)。三组之间比较并发症发生率及治愈率差异均无统计学意义(P>0.05)。三组患儿之间比较平均住院天数及平均住院费用的差异有统计学意义(P<0.05),中剂量组与大剂量组比较患儿的平均住院费用减少,与小剂量组比较患儿的平均住院天数减少。结论三种剂量国产牛肺表面活性物质治疗早产儿呼吸窘迫综合征均具有相似的临床疗效及安全性,但中剂量组与大剂量组比较可有效降低患儿的平均住院费用,与小剂量组比较可有效减少患儿的平均住院天数。Objective To evaluate the clinical curative effect and safety of different doses of calf pulmonary surfactant in the treatment of premature infants with respiratory distress syndrome. Methods The premature infants with respiratory distress syndrome were treated with three different doses of calf pulmonary surfactant. 93 cases met the inclusive criteria among the whole cases. There were 31 cases treated with small doses of calf pulmonary surfac-tant （40-70mg/kg）, 31 cases treated with middle doses of calf pulmonary surfactant （70-100 mg/kg） and 31 ca-ses treated with large doses of calf pulmonary surfactant （100-140mg/kg）. The results of blood gas analysis were compared among the three groups before and after treatment, including pH, arterial oxygen tension and arterial carbon oxygen tension. Other items of comparison included sex, gestational age, birth weight, cesarean section, Apgar scores, amniotic fluid, need for repeated drug use, need for mechanical ventilation, duration of mechanical ventila-tion, duration of oxygen therapy, duration of hospital stay, outcomes, complications and average hospital expenses. Results There was no significant difference in sex, gestational age, birth weight, cesarean section, Apgar scores, amniotic fluid and premature rupture of membranes among the three groups （P〉0. 05）. 6 hours after the first appli-cation of pulmonary surfactant, the pH value and the arterial oxygen tension of the whole infants increased in varying degrees, and the arterial carbon oxygen tension of the whole infants decreased in varying degrees （ P〈0. 05 ） . The differences of pH value, arterial oxygen tension and arterial carbon oxygen tension among the three groups had no sta-tistical significance before the treatment （ P 〉0. 05 ） . The difference of the curative effect among the three groups （ including the need for repeated drug use, the need for mechanical ventilation, the duration of mechanical ventilation and the duration of oxygen therapy） had no statistical signific

关 键 词：牛肺表面活性物质 早产儿 呼吸窘迫综合征 疗效 

分 类 号：R722.6[医药卫生—儿科]