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

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症（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、血气指标的变化、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平均气道压（MAP）显著低于标准剂量组（P<0.05）；高剂量组用药1 h、6 h、12 h后氧浓度（FiO2）显著低于标准剂量组（P<0.05）。高剂量组用药1 h、6 h、24 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（PaO2）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）均显著低于标准剂量组（P<0.05）。高剂量组新生儿肺表面活性物质（PS）用药次数、通气时间均显著少于标准剂量组（P<0.05）。高剂量组并发症发生率为8.18%，明显低于标准剂量组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。

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

Objective: To explore the effects of different doses of bovine pulmonary surfactant (Calsurf) in the treatment of premature infants with respiratory distress syndrome. Methods: 227 premature infants with neonatal respiratory distress syndrome (NRDS) who were treated in our hospital between September 2012 and September 2014 were were selected as the study subjects. All were treated with bovine pulmonary surfactant. The infants were randomly divided into standard dose group (70 mg/kg, 117 cases) and high dose group (140 mg/kg, 110 cases). The changes of ventilator parameters, blood gas indexes at the 1st, 6th, 12th, 24th and 48th hour after drug use, duration of ventilation and incidence of complications were compared between the two groups. Results: After 6 h, 12 h and 24 h of drug use, the mean arterial pressure (MAP) of high dose group was significantly lower than that of standard dose group (P<0.05). After 1 h, 6 h and 12 h of drug use, oxygen concentration (FiO2) of high dose group was significantly lower than that of standard dose group (P<0.05). After 1 h, 6 h and 24 h of drug use, arterial partial pressure of carbon dioxide (PCO2) of high dose group was lower than that of standard dose group while arterial partial pressure of oxygen (PO2) was higher than that of standard dose group (P<0.05); After 6 h, 12 h and 24 h of drug use, OI of high dose group were significantly lower than those of standard dose group (P<0.05). In the high dose group, the times of using pulmonary surfactant (PS), duration of ventilation and hospitalization time 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/kg. Thus, the treatment is safe and effective.