新生儿肺表面活性物质替代疗法常见并发症的防治探讨

目的 对新生儿肺表面活性物质（PS）替代疗法常见并发症的临床特点、诊断及其防治措施进行探讨.方法 对我院新生儿科重症监护病房（NICU）应用PS替代疗法的65例早产儿临床资料进行回顾性分析,分析PS替代治疗常见并发症的发生情况、临床特点、诊断、防治措施及其预后.结果 在65例应用PS的早产儿中,32例发生1～5种并发症,共60例次,其中肺炎14例（21.5%）,肺出血10例（15.4%）,呼吸暂停、脑室内出血（IVH）及支气管肺发育不良（BPD）各8例（12.3%）,动脉导管未闭6例（9.2%）,肺不张及早产儿视网膜病（ROP）各3例（4.6%）.32例极低出生体重儿中,18例发生不同程度并发症（占56.3%）：8例超低出生体重儿中,6例出现并发症（占75.0%）.经综合治疗存活54例,存活率为83.1%.死亡11例,病死率为16.9%.结论 正确应用PS,密切监护病情变化,积极预防、早期发现和及时处理各种并发症,是提高PS替代治疗的效果,降低早产儿RDS死亡率的重要措施.

To investigate the prevention and treatment of common complications of replacement therapy with pulmonary surfactant in neonates

Objective To investigate the clinical characteristic and prophylactic -therapeutic measures of common complications of pulmonary surfactant(PS) replacement therapy in neonates. Methods We analyzed the clinical data of 65 cases preterm neonates treated with PS replacement therapy in neonatal intensive care unit(NICU) of our hospital. Results In 65 cases,32 cases had one to five complications,totally 60 times. Those included 14 times pneumonia (21.5%), 10 times (15.4%)pneumorrhagia, 8times(12.3%) apnoea, intraventricular hemorrhage and bronchopulmonary dysplasia respectively 6 times(9.2%), patent ductus arteriosus, 3 times(4.6%), atelectasis and retinopathy of prematurity respectively 11 times(16.9%). 18 cases Of 32 xtremely low birth weight infants (56.3%) had different degree complications, and as that of 6 cases of 8 very low birth weight infants.54 cases after complex treatment were survival (survival rate 83.1%) and 11 cases died (mortality 16.9%). Conclusion Active precaution and early discovery and treatment all kinds of complications immediately could improve the effect of PS replacement therapy and reduce the mortality of the preterms.