肺表面活性物质治疗早产儿呼吸窘迫综合征疗效观察

目的 探讨肺表面活性物质（PS）治疗早产儿呼吸窘迫综合征（RDS）的临床疗效.方法 86例RDS早产儿采用数字表法随机分为两组,每组各43例,对照组采取经鼻持续气道正压通气（NCPAP）治疗,观察组在此基础上给予气管滴注PS,比较两组治疗前后动脉血气指标变化及转归情况.结果 观察组治疗后PaO2和PaO2/FiO2分别为（67.10 ±3.88） mmHg和（191.30±10.72）,均较治疗前的（43.81±3.78）mmHg和（81.71 ±5.34）及对照组的（53.35 ±3.86） mmHg和（126.88 ±8.50）显著增加（t=9.35、9.50、7.34、7.20,均P＜0.05）;而PaCO2为（37.38±3.65） mmHg,显著低于治疗前的（59.15±4.27） mmHg和对照组的（58.76±3.86） mmHg,差异均具有统计学意义（t=10.15、7.62,均P＜0.05）;观察组治疗后脑室内出血和早产儿视网膜病发生率分别为4.65％和6.98％,均显著低于对照组的13.95％和16.28％（x2=7.68、7.39,均P＜0.05）;而两组BPD发生率比较差异无统计学意义（P＞0.05）.结论 肺表面活性物质治疗早产儿呼吸窘迫综合征疗效显著,可快速、有效的改善患儿肺功能及病情转归和预后.

The clinical effect of pulmonary surfactant in treatment of preterm children respiratory distress syndrome

Objective To discuss the clinical effect of pulmonary surfactant in the treatment of preterm children respiratory distress syndrome （RDS）.Methods 86 RDS premature children were randomly divided into two groups by digital number table methods,43 cases were in each group,the control group was given nasal continuous positive airway pressure （NCPAP） treatment,while the observation group was given intratracheal instillation PS on the basis of the control group.The arterial blood gases,outcome indicators of changes in circumstances were compared between the two groups.Results After treatment,the PaO2 and PaO2/FiO2 of the observation group were （67.10 ±3.88） mmHg and （191.30 ± 10.72） higher than （43.81 ± 3.78） mmHg and （81.71 ± 5.34） of pre-treatment and （53.35 ± 3.86） mmHg and （126.88 ± 8.50） of the control group （t =9.35,9.50,7.34,7.20,all P ＜ 0.05） ; while PaCO2 was （37.38 ± 3.65） mmHg significantly lower than （59.15 ± 4.27） mmHg of pre-treatment and （58.76 ±3.86） mmHg of the control group,the differences were statistically significance （t =10.15,7.62,all P ＜0.05）;after treatment,the IVH and ROP incidence of the observation group were 4.65％ and 6.98％,which were significantly lower than 13.95％ and 16.28％ of the control group （x2 =7.68,7.39,all P ＜ 0.05） ; while the two groups showed no significant difference in incidence of BPD （P ＞ 0.05）.Conclusion Pulmonary surfactant in the treatment of respiratory distress syndrome in premature children has significant effect,and it can improve lung function in children with disease outcome and prognosis.