牛肺表面活性物质不同体位给药对早产儿呼吸窘迫综合征的疗效及安全性  

Efficacy and safety of bovine pulmonary surfactant administered in different positions for preterm neonates with respiratory distress syndrome

作　　者：袁丽君[1] 周丹 崔亚军 张海霞[1] Yuan Li-jun;Zhou Dan;Cui Ya-jun;Zhang Hai-xia(Neonatal Intensive Care Unit,Luohe Central Hospital,Luohe 462000,China)

机构地区：[1]漯河市中心医院新生儿重症监护病房,漯河462000

出　　处：《中国药物应用与监测》2025年第2期301-304,共4页Chinese Journal of Drug Application and Monitoring

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191414)。

摘　　要：目的分析牛肺表面活性物质联合无创高频振荡通气,在不同体位下应用于早产儿呼吸窘迫综合征的治疗效果及其安全性评估。方法挑选2020年1月至2023年12月漯河市中心医院予以针对性治疗的129例呼吸窘迫综合征早产儿为此次试验对象,随机分成A组31例、B组32例、C组32例和D组34例。A、B、C、D组分别采用0°、30°、45°和60°体位注入牛肺表面活性物质,随后联合无创高频振荡通气治疗。观察并记录各组患儿的血气分析指标、治疗效果及并发症发生情况。结果动脉血氧分压、pH值和氧合指数及二氧化碳分压等血气分析指标,治疗后4组患儿的较治疗前均有改善,但D组患儿的pH值(7.38±0.09)高于A组(7.33±0.11),且D组氧合指数[(8.27±0.96)mm Hg(1 mm Hg≈0.133 kPa)]低于其他3组[分别为(11.82±1.15)mm Hg、(11.57±1.20)mm Hg、(11.03±1.19)mm Hg](t=2.013,F=16.634,均P<0.05)。D组患儿有创呼吸支持时间和用氧时间[分别为(3.51±1.32)d、(11.23±3.12)d]均短于其他3组[分别为(5.06±2.04)d、(4.32±1.78)d、(4.76±1.85)d、(16.36±4.71)d、(14.48±4.32)d、(13.79±3.56)d](F=4.826、9.387,P<0.05)。4组患儿在呼吸暂停例数、重复用药例数及无创呼吸支持时间差异无统计学意义(F=1.795、0.714、1.703,均P>0.05)。并发症总发生率,4组患儿对比差异无统计学意义(χ^(2)=4.866,P>0.05),但D组26.47%(9/34)低于A组的51.61%(16/31)(χ^(2)=4.331,P=0.037)。结论牛肺表面活性物质60°体位注入联合无创高频振荡通气在呼吸窘迫综合征早产儿治疗的效果最好,能显著降低氧合指数、缩短有创呼吸机时间和用氧时间,且并发症发生率较低。Objective To investigate the efficacy and safety of bovine lung surface active substance administered in different positions combined with noninvasive high-frequency oscillatory ventilation in preterm infants with respiratory distress syndrome.Methods A total of 129 premature neonates with respiratory distress syndrome admitted to Luohe Central Hospital from January 2020 to December 2023 were randomly divided into group A(n=31),group B(n=32),group C(n=32)and group D(n=34).All the patients in group A,B,C and D were injected with bovine pulmonary surfactant in 0°,30°,45°and 60°positions,respectively,and then they received noninvasive high-frequency oscillatory ventilation.The blood gas indexes,therapeutic effects and complications of the children in each group were observed and recorded.Results Blood gas indexes such as pH,arterial partial pressure of oxygen and carbon dioxide,and oxygenation indicator were improved after treatment compared with before treatment in all four groups of children,but the pH value of the children in group D(7.38±0.09)was higher than that of group A(7.33±0.11)and the oxygenation indicator value of group D((8.27±0.96)mm Hg)was lower than that of the other three groups((11.82±1.15)mm Hg,(11.57±1.20)mm Hg,(11.03±1.19)mm Hg)(t=2.013,F=16.634,all P<0.05).The duration of invasive respiratory support and the duration of oxygen administration of the children in group D((3.51±1.32)d,(11.23±3.12)d)were shorter than those of the other three groups((5.06±2.04)d,(4.32±1.78)d,(4.76±1.85)d,(16.36±4.71)d,(14.48±4.32)d,(13.79±3.56)d)(F=4.826,9.387,P<0.05).There was no significant difference among the four groups in terms of the number of apnea cases,the number of repeat medication cases and the duration of noninvasive respiratory support(F=1.795,0.714,1.703,P>0.05).No statistically significant difference was found in the comparison of the total incidence of related complications among the four groups(χ^(2)=4.866,P>0.05).However,the complication rate of group D was 26.47%(9/34),which wa

关 键 词：牛肺表面活性物质 不同体位给药 无创高频振荡通气 早产儿 呼吸窘迫综合征 安全性 

分 类 号：R722.6[医药卫生—儿科]