肺表面活性剂治疗对新生儿呼吸窘迫综合征肺功能影响的研究

目的观察肺表面活性剂(PS)对新生儿呼吸窘迫综合征(NRDS)肺功能的影响.方法用PS固尔舒治疗10例NRDS患儿.观察治疗前后血气、肺泡充气程度和胸肺总有效动态顺应性的变化.结果用药后30min,PO2和动脉-肺泡氧分压比值(a/APO2)与用药前比较明显升高,用药后1、6、12、24h和3天,PO2和a/APO2仍高于用药前水平,差异均有显著意义(均为P＜0.05).用药后6h,PCO2显著下降,12、24h和3天,PCO2进一步下降,与用药前比较,差异均有显著意义(均为P＜0.05).用药后6h,胸肺总有效动态顺应性较用药前明显升高(P＜0.05),12和24h仍在较高水平,与用药前比较,均为P＜0.01.同时,X线胸片显示肺野透亮度明显改善.结论PS固尔舒能有效改善NRDS的肺换气和通气功能、肺泡充气程度以胸肺总有效动态顺应性.

Effect of pulmonary surfactant replacement therapy on the pulmonary function inneonatal respiratory distress syndrome

Objective To observe the effect of pulmonary surfactant(PS)replacement therapy on the pulmonary function in neonatal respiratory distress syndrome(NRDS).Methods 10 NRDS infants were treated with Curosurf.The change of the blood gases,lung aerovation and lung thorax dynamic compliance were observed after therapy.Results 30 mins after the administration of Curosurf,PO 2 and a/APO 2 increased significantly.The high levels of PO 2 and a/APO 2 remained until 3 days after the administration and were significantly different from the levels before the treatment (P<0.05).6 hrs after the drug administration,PCO 2 decreased remarkably and chest X-ray showed a significant improvement in lung aerovation.The lung thorax dynamic compliance improved significantly from 6 hrs of the medication and remained at high level after 24 hrs.Conclusion Curosurf could improve pulmonary oxygenation,ventilation,lung aerovation and lung thorax dynamic compliance effectively in NRDS infants.