ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2016, Vol. 8 ›› Issue (5): 492-494.doi: 10.3969/j.issn.167-43865.2016.05.010

• 临床研究 • 上一篇    下一篇

肺表面活性物质治疗足月新生儿急性呼吸窘迫综合征疗效观察

张小春   

  1. 417000 湖南 娄底，娄底市中心医院新生儿科
  • 出版日期:2016-10-25 发布日期:2017-12-08
  • 作者简介:张小春(1979-)，女，医学硕士，主治医师。研究方向：新生儿疾病的诊断与治疗

Effect of pulmonary surfactant therapy for full-term neonates with acute respiratory distress syndrome

ZHANG Xiaochun   

  1. Loudi Central Hospital，Loudi 417000，China.
  • Online:2016-10-25 Published:2017-12-08

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摘要：
目的：观察肺表面活性物质(PS)治疗足月新生儿急性呼吸窘迫综合征(ARDS)的临床疗效。
方法：2011年1月至2016年1月娄底市中心医院新生儿科收治住院的足月ARDS新生儿86例，随机分为观察组和对照组各43例。对照组给予机械通气和常规药物治疗，观察组在对照组治疗基础上同时经气管插管给予患儿肺泡表面活性物质猪肺磷脂注射液治疗，疗程1～7 d。观察两组患儿机械通气时间、用氧时间、呼吸指数、氧合指数及临床疗效。
结果：观察组总有效率为90.69%(39/43)，显著高于对照组69.76%(30/43)，差异有统计学意义(P<0.05)；观察组患儿的机械通气时间、用氧时间、高浓度氧持续时间、氧合指数、呼吸指数均较对照组有明显改善，差异有统计学意义(P<0.05)；经PS治疗后观察组并发症发生率为16.28%(7/43)，显著低于对照组44.19%(19/43)，差异有统计学意义(P<0.05)。
结论：在ARDS治疗早期应用PS可有效改善肺氧合功能，很大程度地缩短了机械通气时间和用氧时间，降低ARDS的并发症发生率，是一种比较安全有效的治疗方法，对临床上大范围推广具有一定意义。

关键词: 急性呼吸窘迫综合征, 肺表面活性物质, 足月, 婴儿, 新生

Abstract:
Objective:To observe the clinical curative effect of pulmonary surfactant(PS) in the treatment of neonatal acute respiratory distress syndrome(ARDS).
Methods:From January 2011 to January 2016,86 patients with ARDS in Loudi Central Hospital were involved in this study,and they were randomly divided into the observation group and the control group with 43 cases in each group.The control group was given mechanical ventilation and conventional drug treatment,while the observation group was given endotracheal intubation with pulmonary surfactant treatment of Poractant Alfa Injection in addition to the treatment for control group,1~7 days as a course.The mechanical ventilation time,oxygen time,respiratory index,oxygenation index and clinical effect of the two groups were observed.
Results:The total effective rate of observation group was 90.69%(69.76%,39/43),which was significantly higher than that of control group(30/43),and the difference was statistically significant(P<0.05).In the observation group,mechanical ventilation time,oxygen time,duration of high concentration of oxygen,oxygenation index and respiratory index were more significantly improved compared with those of the control group,the difference being statistically significant(P<0.05).After PS treatment,the incidence of complications was 16.28%(7/43),significantly lower than the control group(44.19%,19/43),and the difference was statistically significant(P<0.05).
Conclusion:In the treatment of ARDS early application of PS can effectively improve oxygenation function,greatly shorten the time of mechanical ventilation and oxygen use,and reduce the incidence of ARDS complications,so it is a safe and effective treatment method for a wide range of clinical promotion.

Key words: Acute respiratory distress syndrome, Pulmonary surfactant, Term, Infant,newborn