| 摘要: |
| 目的:探讨不同剂量国产牛肺表面活性物质(PS)对严重呼吸窘迫综合征早产儿的疗效,以期为临床治疗提供参考。方法:回顾我院2012年1月至2016年3月NICU住院的82例使用了PS的严重RDS早产儿病例。收集患儿的一般情况、PS使用情况以及住院、氧疗、机械通气和经鼻持续气道正压通气(nCPAP)时间和使用PS前后的氧合指数(OI)、并发症、治疗转归情况。按照PS实际使用量分为低剂量组(每次40~69 mg/kg)和高剂量组(每次70~100 mg/kg)。结果:低剂量组和高剂量组的一般情况、使用PS前OI、PS重复使用率、并发症及住院、氧疗、机械通气、nCPAP时间差异均无统计学意义(P均>0.05)。高剂量组需重复使用PS间隔时间为(18.8±2.4)h,显著长于低剂量组的(16.8±2.3) h ( Z=2.81,P<0.01)。使用PS后,两组病例12 h的OI均显著下降,且高剂量组OI在12 h、48 h和72 h持续下降(P均<0.05),但低剂量组OI在24~48 h无明显改善。同一时间点的横向比较显示,高剂量组OI改善优于低剂量组(P均<0.05)。高剂量组48例患儿中,存活45例(93.8%);低剂量组34 例患儿中,存活25 例(73.5%),高剂量组存活率高于低剂量组(χ2=5.00,P<0.05)。结论:高剂量较低剂量国产牛PS不但能显著降低严重RDS早产儿的OI和病死率,还能延长需重复使用PS间隔时间。 |
| 关键词: 早产儿 呼吸窘迫综合征 牛肺表面活性物质 剂量 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2017.10.009 |
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| 基金项目: |
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| Efficacy of Different Doses of Domestic Bovine Pulmonary Surfactant in Preterm Infants with Severe Respiratory Distress Syndrome |
| Wang Mokui, Huang Wei, Su Huaying, Yang Jiemei, Wang Qin, Lyu Yongbin, Lu Ting, Gu Li |
| (The First People's Hospital of Yibin City, Sichuan Yibin 644000, China) |
| Abstract: |
| Objective: To evaluate the efficacy of different doses of domestic bovine pulmonary surfactant (PS) in preterm infants with severe respiratory distress syndrome (RDS) for the expectation to offer information for clinical treatment. Methods: Retrospected the data of 82 preterm infants, who were treated in NCIU of our hospital and had been administrated bovine PS because of severe RDS, from January 2012 to March 2016. Data were collected, such as general information, condition of PS administration, hospital stay, and the time of oxygen therapy, mechanical ventilation, nasal continuous positive airway pressure (nCPAP), oxygenation index(OI)before and after PS administration, complications and outcomes. All children were classified into low dose group (40~69 mg/kg) and high dose group (70~100 mg/kg) according to the dosage of PS. Results: All the general information, OI before PS administration, complications, the repetition rate of PS, hospital stay, and the time of oxygen therapy, mechanical ventilation, nCPAP were not significant differences between the two groups (all P>0.05). In high dose group, the repetition rate of PS was (18.8±2.4) h, longer than that in low dose group (16.8±2.3) h (Z=2.81, P<0.01). After PS administration, OI in 12 h were significantly decreased in the two groups. Further more, OI in 12 h, 48 h and 72 h were continue decreased in high dose group (all P<0.05), but no significant improvement was found in low dose group during 24 to 48 h. In horizontal comparisons, the improvement of OI was better in high dose group than those in low dose group at all the same point (P<0.05). There were 45 survivors (93.8%) and 25 survivors (73.5%) in high dose group and low dose group, respectively. The survival rate was significant higher in high dose group than that in low dose group (χ2=5.00, P<0.05). Conclusion: High dose of domestic bovine PS can not only reduce the OI and mortality in preterm infants with server RDS, but also delay the interval reuse of PS. |
| Key words: preterm infant respiratory distress syndrome bovine pulmonary surfactant dose |
