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| 河南省肺表面活性物质在新生儿呼吸窘迫综合征的可及性与临床应用现状: 医药双视角多中心横断面研究 |
| 苏冉1,张双1,孙楠1,刘青蓝1,郭华1,黄春芝1,赵彩艳1,李书津1,杨文辉1,王晓玲2 |
| (1. 郑州大学第三附属医院, 郑州 450052; 2. 首都医科大学附属北京儿童医院,北京 100045) |
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| 摘要: |
| 目的:调查河南省新生儿呼吸窘迫综合征(NRDS)治疗中肺表面活性物质(PS)的可及性及临床应用现状,为优化 PS 供 应保障、提升 NRDS 救治能力提供决策参考。 方法:对河南省危重新生儿救治中心的药师(聚焦 PS 配备和供应管理)和新生儿 科医师(聚焦 PS 临床应用实践)分别进行问卷调查。 结果:最终纳入覆盖河南省五大地理区域、18 个地市的 117 家医疗机构的 有效问卷。 PS 总体配备率 78. 63%,二级医院、豫南地区配备率偏低。 多因素 logistic 回归分析显示,医院等级、是否为豫南地区 是 PS 配备的独立影响因素。 诊疗能力不足是未配备 PS 的主要原因。 PS 供应整体稳定,但临采中 23. 81%耗时>48 h。 临床首 剂剂量应用基本规范,微创给药开展率 35. 87%,二级医院微创给药开展率(15. 79%)显著低于三级医院(41. 10%)。 药品价格 是制约 PS 配备与临床应用的共性因素,基本药物政策影响较弱。 结论:河南省 PS 配备总体良好,但级别与地域差异显著,部分 医院可获得与及时获得之间存在差距;微创给药开展率与国际相当但二级医院普及不足。 建议加强二级医院和豫南地区供应 保障,推动微创给药技术培训下沉,促进国家基本药物政策与临床实践协同落地。 |
| 关键词: 新生儿呼吸窘迫综合征 肺表面活性物质 可及性 临床应用 多中心横断面调查 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2026.09.001 |
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| 基金项目:国家重点研发计划资助项目,编号 2023YFC2706100;中国青年医学创新研究科研课题。 |
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| Accessibility and Clinical Application of Pulmonary Surfactant for Neonatal Respiratory Distress Syndrome in Henan Province: a Multicenter Cross-Sectional Study from Perspectives of Clinicians and Pharmacists |
| Su Ran1 , Zhang Shuang1 , Sun Nan1 , Liu Qinglan1 , Guo Hua1 , Huang Chunzhi1 , Zhao Caiyan1 , Li Shujin1 , Yang Wenhui1 , Wang Xiaoling2 |
| (1. The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; 2. Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China) |
| Abstract: |
| Objective: To investigate the accessibility and clinical application of pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome ( NRDS) in Henan, and to provide decision-making references for optimizing the supply of PS and enhancing the treatment capacity of NRDS. Methods: Questionnaire survey was separately performed on pharmacists (focusing on the preparation and supply management of PS) and neonatologists ( focusing on the clinical application practice of PS) at the Critical Newborn Care Center in Henan. Results: Valid questionnaires from 117 medical institutions covering 18 cities and five geographical regions across Henan were enrolled. The overall availability rate of PS was 78. 63%, and it was significantly lower in secondary hospitals and the southern Henan. Multivariate logistic regression analysis indicated that hospital grade and whether located in southern Henan were independent influencing factors for PS supply. The major factor for non-availability of PS was insufficient diagnostic and therapeutic capacity. The PS supply was generally stable, however 23. 81% of temporary procurement orders took more than 48 h. The initial dose of PS in the treatment of NRDS was generally standardized. The overall adoption rate of less invasive surfactant administration was 35. 87%. Notably, the rate in secondary hospitals (15. 79%) was significantly lower than that in tertiary hospitals (41. 10%). Drug price was a common factor restricting the supply and clinical application of PS, and the basic drug policy had a relatively weak impact. Conclusion: The overall availability of PS in Henan is satisfactory, but there are significant differences across hospital grades and geographic regions. Furthermore, a discrepancy is identified between the availability of PS and its timely access in some hospitals. The adoption rate of less invasive surfactant administration is comparable to international levels, yet its popularization in secondary hospitals still inadequate. It is recommended to strengthen supply guarantee in secondary hospitals and southern Henan, promote training of less invasive surfactant administration in secondary hospitals, and facilitate the coordinated implementation of the national essential medicine policy with clinical practice. |
| Key words: neonatal respiratory distress syndrome pulmonary surfactant accessibility clinical application multicenter cross-sectional survey |
