目的 探讨早产儿预防性使用肺表面活性物质的效果,为预防早产儿呼吸窘迫综合征提供科学依据。方法 在广州市两家三甲医院,选取91例早产儿预防性使用牛肺磷脂针(珂立苏),90例早产儿作为对照组,开展干预研究。调查两组早产儿干预前后不同时段的氧分压(PO2)、二氧化碳分压(PCO2)、血氧饱和度(SPO2)等指标及新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)发生情况。结果 两组早产儿性别、母亲基础疾病和新生儿疾病等因素分布均衡,干预前PO2、PCO2和SPO2差异均无统计学意义(P均>0.05)。用珂立苏1、6、12、24 h后干预组的PO2、PCO2均显著高于对照组,干预组NRDS的发生率(20%)亦显著低于对照组(60%),干预组呼吸机使用时间低于对照组。干预组早产儿使用牛肺磷脂针 1、6、12、24 h后的PO2均显著高于用药前,PCO2均显著低于用药前。30周以上早产儿预防性使用牛肺磷脂针后SPO2和PCO2改善更好。结论 预防性使用肺表面活性物质可有效改善肺通气情况和氧合能力,降低NRDS的发生率,减少呼吸机使用时间。对30周以后的早产儿预防使用珂立苏效果更好。
Abstract
Objective To investigate the preventive effect of pulmonary surfactant (PS) on neonatal respiratory distress syndrome (NRDS) in preterm infants. Methods Intervention study was used.A total of 91 premature infants were selected as prevented group to receive PS,and 90 premature infants were selected as control group.All infants came from two hospitals in Guangzhou.General situation,oxygen partial pressure (PO2),carbon dioxide partial pressure (PCO2) and oxygen saturation (SPO2) index during different periods before and after treatment,NRDS outcome between the two groups were investigated. Results The demographic variables between the two groups were comparable.Before receiving PS,the PO2,PCO2 and SPO2 between the two groups were not significantly different.The values of PO2 and PCO2 after 1,6,12,24 hours of treatment in prevented group were significantly higher than those in control group.The NRDS incidence rate of prevented group (20%) was significantly lower than control group (60%).The using time of respirator and medical costs of prevented group were lower than those of control group.For the prevented group,SPO2 values after 1,6,12,24 hours of PS using were significantly higher than that before treatment,and PCO2 values were significantly lower than that before treatment.The preventive effect was better for infants with 30~34 gestational weeks than those less than 30 gestational weeks. Conclusions The preventive use of PS can effectively improve the pulmonary ventilation and oxygenation capacity,reduce the incidence of NRDS.And it can also reduce mechanical ventilation using time.The effect is better for premature infants with 30~34 gestational weeks.
关键词
肺表面活性物质 /
新生儿呼吸窘迫综合征 /
早产儿
Key words
pulmonary surfactant /
neonatal respiratory distress syndrome /
preterm infants
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参考文献
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基金
广州市医药卫生科技项目(20121A011161)
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