肺表面活性物质预防早产儿呼吸窘迫综合征的疗效观察

目的:探讨早产儿生后6 h内使用牛肺表面活性剂(PS)预防新生儿呼吸窘迫综合征(NRDS)的疗效。方法:我院出生的76例胎龄28～32周的早产儿随机分为两组,预防组38例给予气管内注入40～100 mg/kg牛肺表面活性剂与未用PS的对照组38例进行前瞻性临床研究,比较两组NRDS的发生情况。结果:预防组发生NRDS 5例,对照组发生NRDS 17例,两组比较差异有统计学意义(P<0.05)。预防组吸氧天数(9.2±6.1)d、呼吸机使用天数(6.5±4.9)d及住院天数(29.3±7.8)d,较对照组(16.7±6.4)d、(9.8±7.0)d、(37.4±7.2)d明显缩短,差异有统计学意义(P<0.05)。预防组肺部并发症如肺部感染及支气管肺发育不良较对照组明显减少,两组比较差异有统计学意义(P<0.05)。结论:早产儿预防性使用牛肺表面活性剂能减少NRDS的发生率,减少呼吸机的使用,减少肺部并发症发生,改善早产儿预后。

The Preventive Effect of Pulmonary Surfactant in Respiratory Distress Syndrome on Premature Infants

Objective:To investigate the effect of pulmonary surfactant(PS) in preventing 6 hour old premature infants from respiratory distress syndrome(RDS).Methods:Together 76 premature infants of gestational age of 28~32 weeks born in our hospital were divided into two groups randomly.In prevention group,38 cases were dripped with 40~100 mg/kg of calf PS through trachea in comparison with the measures taken in the control group.They were assigned to be prevented from incidence of RDS.Results:The incidences of RDS were 5 cases in prevention group compared to 17 cases in control group(P<0.05).The time of oxygen supply(9~15 d),the time of mechanical ventilation dependence(6~11 d) and hospital stay(29~36 d) of the prevention group were shorter than those of the control group(16~23 d,10~16 d,37~44 d),and there had a significant difference between the control group and the prevention group(P<0.05).Pulmonary complication such as pulmonary infection and bronchopulmonary dysplasia in prevention group were obviously less than those in the control group(P<0.05).Conclusions:The preventive administration of calf PS for premature infants can reduce the rate of RDS and mechanical ventilation dependence,decrease pulmonary complication,and improve the prognosis.