不同肺表面活性物质对新生儿呼吸窘迫综合征患儿影响的对比研究

摘要

目的：比较猪肺表面活性物质和牛肺表面活性物质对新生儿呼吸窘迫综合征患儿的影响。方法前瞻性收集内蒙古医科大学附属医院儿科2012—2015年收治的新生儿呼吸窘迫综合征患儿80例，根据随机对照原则分为对照组和研究组，每组40例。两组患儿均给予持续气道正压通气（CPAP），对照组患儿给予牛肺表面活性物质治疗，研究组患儿给予猪肺表面活性物质治疗。比较两组患儿治疗前、治疗24 h 后血气分析〔动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、pH 值〕，CPAP 持续时间、给氧时间及住院时间，观察两组患儿并发症发生情况和院内死亡情况。结果治疗前及治疗24 h 后两组患儿 PaO2、PaCO2和 pH 值比较，差异无统计学意义（P >0.05）；治疗24 h后，两组患儿 PaO2和 pH 值高于治疗前，PaCO2低于治疗前（P <0.05）。研究组 CPAP 持续时间、给氧时间及住院时间短于对照组（P <0.01）。两组患儿颅内出血、肺气漏、呼吸机相关性肺炎、支气管肺发育不良发生率及和院内病死率比较，差异无统计学意义（P >0.05）。结论与牛肺表面活性物质相比，猪肺表面活性物质治疗新生儿呼吸窘迫综合征患儿可更有效地缩短 CPAP 持续时间、给氧时间和住院时间。%Objective To compare the influence on neonatal respiratory distress syndrome( NRDS) between pig pulmonary surfactant and cow pulmonary surfactant. Methods A total of 80 newborns with NRDS were prospectively collected in the Affiliated Hospital of Inner Mongolia Medical University from 2012 to 2015,and they were divided into control group and study group according to randomized controlled principle,each of 40 cases. Based on continuous positive airway pressure ventilation,newborns of control group received cow pulmonary surfactant,newborns of study group received pig pulmonary surfactant. Blood - gas analysis results( including PaO2 ,PaCO2 and pH) before treatment and after 24 hours of treatment, duration of continuous positive airway pressure ventilation and oxygen inhalation,hospital stays,incidence of complications and in - hospital death were compared between the two groups. Results No statistically significant differences of PaO2 ,PaCO2 or pH was found between the two groups before treatment or after 24 hours of treatment(P > 0. 05);after 24 hours of treatment, PaO2 and pH of the two groups were statistically significantly higher than those before treatmen,while PaCO2 of the two groups was statistically significantly lower than that before treatment,respectively(P < 0. 05). Duration of continuous positive airway pressure ventilation and oxygen inhalation,and hospital stays of study group were statistically significantly shorter than those of control group(P < 0. 01). No statistically significant differences of incidence of intracranial hemorrhage,pulmonary air leak, ventilator - associated pneumonia or bronchopulmonary dysplasia,or in - hospital fatality rate was found between the two groups (P > 0. 05). Conclusion Compared with cow pulmonary surfactant,pig pulmonary surfactant can more effectively shorten the duration of continuous positive airway pressure ventilation and oxygen inhalation,and hospital stays.