首剂大剂量肺表面活性物质治疗重度新生儿肺透明膜病临床观察

目的比较首剂不同剂量的肺表面活性物质(PS)对新生儿肺透明膜病(HMD)治疗效果的影响。方法随机将2006年6月至2007年6月广东省妇幼保健院48例Ⅲ、Ⅳ级HMD早产儿分为两组：首剂大剂量组(PS治疗剂量150~200 mg/kg)和首剂小剂量组(PS治疗剂量50~100 mg/kg)。比较两组患儿用药次数、用药总剂量，使用6 h后血气分析，PaO2/FiO2，呼吸机通气治疗时间以及监护室住院时间等。结果两组治疗用药总剂量差异无统计学意义，首剂大剂量组的机械通气时间、氧疗时间、监护室住院时间显著低于首剂小剂量组，治疗后6 h两组的PaO2，PaO2/FiO2均显著升高，但升高程度两组间差异无统计学意义。结论PS首剂治疗量达150~200 mg/kg时治疗重度HMD的效果优于首剂治疗量为50~100 mg/kg,值得在临床中推广。

Effects of large first dose pulmonary surfactant on treatment of severe hyaline membrane disease in neurates.

ObjectiveTo investigate the effect of large first dose of pulmonary surfactant on treatment of severe hyaline membrane disease (HMD) in neurates.MethodsFourty-eight preterm newborns with Ⅲ~Ⅳ degree HMD were randomly allocated into experimental and control groups: the large first dose group was administered surfactant (150~200) mg/kg and the small first dose group(50~100) mg/kg.Times of administration,total dosage,blood gas analysis,PaO2/FiO2,duration of mechanical ventilation and length of stay in NICU were compared between two groups.ResultsThe duration of ventilation,duration of oxygen therapy,length of stay in NICU and incidence of bronchopulmonary dysplasia in the large first dose group were less than that in small dose group.ConclusionEffects of large first dose of surfactant (200 mL/kg) are better than small first dose (100 mg/kg) on the treatment of severe HMD.