肺表面活性物质治疗新生儿呼吸窘迫综合征的临床研究

目的探讨肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征(NRDS)的疗效及临床价值。方法对50例NRDS患儿用固尔苏治疗,观察治疗前后患儿肺功能、胸部X线片、呼吸机参数的变化。结果应用PS治疗后1小时患儿PaO_2和动脉-肺泡氧分压比值 a/APO_2、PaO_2/FiO_2,pH值明显上升,PaCO_2显著下降。用药后1h、6h、12h、24h、48h、72h的PaO_2、a/APO_2、PaPO_2/FiO_2、pH、PCO_2与用药前比较,差异均有非常显著意义(P均<0.01)。治疗1小时后,FiO_2渐下降;各观察时间点的FiO_2与用药前比较,差异均有非常显著意义(P<0.01)。平均气道压(MAP)在用药后12h内无明显变化;用药12h后开始显著下降。与用药前比较,差异均有显著意义(P均<0.05)。PS治疗后6小时,胸部X线片显示肺野透亮度明显改善;与用药前比较,差异有非常显著意义(P<0.01)。结论 PS固尔苏能有效地改善NRDS的肺换气和通气功能以及肺泡充气程度。

Clinical effect of the surfactant replacement therapy for neonatal respiratory distress syndrome

Objective To study the efficacy and clinical value of pulmonany surfactant (PS) replacement therapy for newborn infants with respiratory distress syndrome (NRDS) .Methods: Fifty NRDS infants were treated with curosurf which is one of the PS. The changes of the lung function and lung aeration after the therapy were observed. Result: An hour after the administration of curosurf, PaO2 and a/APO2 increased significantly.The high levels of PaO2 and a/APO2 remained until 3 days after the administration and were significantly different from the levels before the treatment (P< 0.01) .PCO2 fraction of inspired oxygen (FiO2) , and mean airway pressure (MAP) decreased gradually. After six hours of the administration, chest X- ray showed a significant improvement in lung aeration (P < 0.01) .Conclusion: Cursurlf could effectively improve pulmonary oxygenation, ventilation, lung aeration in NRDS infants.