不同剂量牛肺表面活性物质治疗早产儿呼吸窘迫综合征的临床研究  

Different Doses of Bovine Pulmonary Surfactant in the Treatment of Premature Infants with Respiratory Distress Syndrome

作　　者：李文[1] 孙爱荣 姜红[3] 赵日明 许平[5] 刘建红[6] 张成元[7] 牛世平 江丽[9] 邱丙平[10] 姚国[11] 张志明[12] 陈为兵[13] 刘秀香[14] 王瑜[15] 

机构地区：[1]山东大学齐鲁医院,山东济南250012 [2]临沂市妇幼保健院,山东临沂276004 [3]青岛大学医学院附属医院,山东青岛266003 [4]莒县人民医院,山东日照276500 [5]聊城市人民医院,山东聊城252002 [6]济南市儿童医院,山东济南250022 [7]潍坊市妇幼保健院,山东潍坊261011 [8]淄博市妇幼保健院,山东淄博255000 [9]德州市人民医院,山东德州253045 [10]滕州市中心人民医院,山东滕州277500 [11]泰安市中心医院,山东泰安271000 [12]胜利油田中心医院,山东东营257034 [13]日照市人民医院,山东日照276800 [14]滨州医学院附属医院,山东滨州256603 [15]济宁医学院附属医院,山东济宁272000

出　　处：《儿科药学杂志》2016年第12期13-16,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨不同剂量牛肺表面活性物质(珂立苏)治疗早产儿呼吸窘迫综合征的临床疗效。方法:选取我院2012年9月至2014年9月收治的227例新生儿呼吸窘迫综合征(NRDS)早产儿作为研究对象,均给予牛肺表面活性物质治疗,将患儿随机分为标准剂量组(70 mg/kg)117例、高剂量组(100 mg/kg)110例,比较两组用药后1 h、6 h、12 h、24 h、48 h呼吸机参数、血气指标、通气时间和并发症发生率。结果:高剂量组用药6 h、12 h、24 h、48 h平均气道压(MAP)低于标准剂量组(P<0.05);高剂量组用药1 h、6 h、12 h、24 h、48 h后吸入氧浓度(Fi O2)低于标准剂量组(P<0.05)。高剂量组用药1 h、6 h、24 h、48 h动脉血二氧化碳分压(PCO2)均低于标准剂量组,动脉血氧分压(PO2)高于标准剂量组(P<0.05);高剂量组用药6 h、12 h、24 h后氧合指数(OI)均低于标准剂量组(P<0.05)。高剂量组新生儿肺表面活性物质(PS)用药次数、通气时间均少于标准剂量组(P<0.05)。高剂量组并发症发生率为8.18%,低于标准剂量组的18.80%(P<0.05)。结论:牛肺表面活性物质治疗NRDS时,首剂用药剂量应满足100 mg/kg,安全有效。Objective： To explore the effects of different doses of bovine pulmonary surfactant（Calsurf） in the treatment of premature infants with respiratory distress syndrome.Methods： Two hundreds and twenty-seven premature infants with neonatal respiratory distress syndrome（NRDS） were selected as the study subjects.All children were treated in our hospital from September 2012 to September2014.All children were randomly divided into standard dose group（117 cases） and high dose group（110 cases）,standard dose group was treated with bovine pulmonary surfactant 70 mg / kg,high dose group was treated with bovine pulmonary surfactant 100 mg / kg.The changes of ventilator parameters,blood gas indexes at the 1st,6th,12 th,24thand 48 thhour after drug use,duration of ventilation and incidence of complications were compared between the two groups.Results： After 6 hours,12 hours,24 hours and 48 hours,the mean arterial pressure（MAP） of high dose group were significantly lower than those of standard dose group（P 0.05）.After 1 hour,6hours,12 hours,24 hours and 48 hours,oxygen concentration（Fi O2） of high dose group were significantly lower than those of standard dose group（P〈0.05）.After 1 hour,6 hours,24 hours and 48 hours,arterial partial pressure of carbon dioxide（PCO2） of high dose group were lower than those of standard dose group while arterial partial pressure of oxygen（PO2） were higher than those of standard dose group（P〈0.05）.After 6 hour,12 hours and 24 hours,OI of high dose group were significantly lower than those of standard dose group（P〈0.05）.In the high dose group,the time of using pulmonary surfactant（PS） and duration of ventilation were significantly less than those in standard dose group（P〈0.05）.The incidence rate of complications in high dose group（8.18%） was significantly lower than that in standard dose group（18.80%,P 0.05）.Conclusion： When using Calsurf in the treatment of premature infants with NRDS,the first dose should be 100 mg /

关 键 词：新生儿呼吸窘迫综合征 早产儿 牛肺表面活性物质 用药剂量 血气指标 

分 类 号：R722.6[医药卫生—儿科]