机械通气下不同时段使用猪肺表面活性物质治疗早产儿呼吸窘迫综合征的临床疗效观察  

The clinical efficacy of mechanical ventilation in different periods using pulmonary surfactant therapy in premature infants with respiratory distress syndrome

作　　者：杜书华[1] 陈娟[1] 陈德忠[1] 王利平[1] 雷贤明[1] 曹云涛[1] 

机构地区：[1]遵义医学院附属医院新生儿科,贵州遵义563000

出　　处：《泰山医学院学报》2016年第7期772-773,共2页Journal of Taishan Medical College

摘　　要：目的研究不同时间段使用猪肺表面活性物质治疗早产儿呼吸窘迫综合征的疗效差异。方法在采用机械通气的前提下,根据用药时段的不同将150例呼吸窘迫综合征早产儿随机分为A组、B组和C组。A组50例,于出生后6 h内用药,B组50例,于出生后6-12 h内用药,C组50例,于出生后12-48 h内用药。比较三组患者治疗前后血气分析指标及治疗情况。结果治疗前三组血气分析参数无显著差异（P〉0.05）;经治疗后,三组Pa O2均显著上升、Pa CO2均显著下降（P〈0.05）,p H值无明显变化（P〉0.05）;A组患儿血气改善优于其他两组。A组与B组并发症发生率、死亡率均无显著差异（P〉0.05）;A组与C组并发症发生率差异显著（P〈0.05）,死亡率无显著差异（P〉0.05）。结论在机械通气下不同时间段使用猪肺表面活性物质均可取得显著疗效,但6 h内用药患儿血气改善更为显著、并发症发生率更低。Objective： To study clinical difference in different periods using porcine pulmonary surfactant therapy in premature infants with respiratory distress syndrome. Methods ： Under the mechanical ventilation, 150 cases of premature in- fants with respiratory distress syndrome were randomly divided into A group, B group and C group according to the different time of medication. The Group A of 50 cases were given the drug after the birth, 50 cases within the group B after 6 -12h of birth, and the group C of 50 cases after 12 -48h of birth. Blood gas analysis of the indexes and treatment of the three groups were compared before and after treatment. Results： Blood gas analysis parameters had no significant difference in three groups before treatment （ P 〉 0.05 ） ; PaO2 increased significantly, PaCO2 significantly decreased （ P 〈 0. 05 ）, pH value had no significant change（P 〉0. 05） , in the three groups after treatment; blood gas in Group A was better than that in the other two groups. There was no significant difference in the incidence of complications and mortality between the A group and the B group（ P 〉 0.05 ）. There was no significant difference in the incidence of complications （P 〈 0.05 ）, and there was no significant difference between the A group and the C group（ P 〉 0. 05 ）. Conclusion： Porcine pulmonary surfac- tant under mechanical ventilation at different times can be used to obtain significant curative effect, but more significant im- provement can be made in treatment in children with blood gas within 6 hours and the incidence of complications is low.

关 键 词：机械通气 呼吸窘迫综合征 早产儿 猪肺表面活性物质 

分 类 号：R722.6[医药卫生—儿科]