肺表面活性物质对不同胎龄呼吸窘迫综合征早产儿的疗效

目的探讨肺表面活性物质(PS)对不同胎龄呼吸窘迫综合征(RDS)早产儿的疗效差异,以及应用PS预防RDS的最佳时机。方法选择2003年1月至2011年8月入院胎龄28～35周的早产儿207例,其中应用PS 93例(应用组),未应用PS 114例(未应用组)。比较两组不同胎龄早产儿的患病率、5 d内病死率、机械通气时间、氧疗时间、住院时间以及主要并发症的发生情况。结果应用组RDS患病率比未应用组降低了27.0%(P<0.05)。应用组5 d病死率(5.94%)比未应用组(17.7%)明显降低(P<0.05);应用组机械通气时间、氧疗时间比未应用组明显减低(P<0.05);但住院时间两组无显著性差异(P>0.05)。应用组肺出血,肺炎发生率均低于未应用组(P<0.05)。结论应用PS可减少RDS患病率,降低早产儿的病死率,缩短机械通气时间和氧疗时间,减少肺出血、呼吸机相关性肺炎的发生率。

The Effect of Pulmonary Surfactant Therapy on Preterm Infants with Respiratory Distress Syndrome at Different Gestational Ages

Objective To explore the difference of effect of pulmonary surfactant(PS)therapy on preterm infants with respiratory distress syndrome(RDS)at different gestational ages.Methods 207 cases RDS preterm infants at gestational age 28-35 weeks,from January 2003 to August 2011 were included,93 cases were given PS classified as Group A,and the other 114 babies not given PS as Group B.RDS morbidiy and mortality within 5 days,as well as the period of mechanical ventilation,oxygen therapy and hospitalization and major complications were analyzed statistically in both groups.Results Compared to Group B,RDS morbidiy within 5 days was significantly lower by 27.0%(p<0.05)in Group A.A significant difference in the 5 days mortality was observed between Group A(5.94%)and Group B(17.7%)(P<0.05).There were significant differences in the time of ventilation and oxygen therapy(P<0.05),but no difference was showed in the time of hospitalization between the two groups(P>0.05).Compared to Group B,Group A had a lower incidence of lung hemorrhage,ventilator-associated penumonia(P<0.05).Conclusion Administration of PS results in lower RDS morbidity and mortality,shortened time of ventilation and oxygen therapy,as well as reduced complication incidence such as lung hemorrhage,ventilator-associated pneumonia.