不同剂量固尔苏对极低出生体重儿呼吸窘迫综合征的疗效比较

摘要

Objective To observe the clinical effects of different doses of curosurf in treating the complicating respiratory distress syn-drome ( RDS ) of very low birth weight infants. Methods The data in 140 very low birth weight neonates with complicating RDS from January 2008 to January 2013 were performed the retrospective analysis. These neonates were divided into the low dose curosurf group ( 100 mg/kg ) and the high dose curosurf group ( 200 mg/kg ) . The efficacy and adverse reactions were compared between the two groups. Results PaO2 and oxygen index ( OI ) were elevated, and fraction of inspiration O2 ( FiO2 ) and difference of alveoli-arterial oxygen pressure ( A-aDO2 ) were decreased in all cases; moreover the changes in the high-dose curosurf group were more than those in the low dose curosurf group ( P﹤0. 05 ) . The application of mechanical ventilation and nasal continuous positive airway pressure ( nCPAP ) in the high dose curosurf group was significantly lower than that in the low dose curosurf group ( P﹤0. 05 ) . There were no statistically sig-nificant differences in the aspects of the oxygen therapy duration, mechanical ventilation time, hospitalization time and adverse reactions between the two groups ( P﹥0. 05 ) . Conclusion High-dose curosurf ( 200 mg/kg ) is safe in treating the very low birth weight neonates with complicating RDS, and can effectively improve the pulmonary oxygenation function and reduce the application of assisted ventilation.%目的：观察不同剂量固尔苏对极低出生体重儿呼吸窘迫综合征的疗效。方法对2008年1月至2013年1月收治的140例患儿临床资料进行回顾性分析。按固尔苏应用剂量分为小剂量组(100 mg/kg )和大剂量组(200 mg/kg )，比较两组的疗效和不良反应。结果所有患儿治疗后动脉氧分压（PaO2）、氧合指数( OI )上升，吸入氧浓度( FiO2)、肺泡动脉氧分压差（A－aDO2）下降，且大剂量组变化大于小剂量组（ P﹤0.05）。大剂量组机械通气和鼻塞式持续正压通气（nCPAP）应用明显低于小剂量组( P﹤0.05）。两组在氧疗时间、机械通气时间、住院时间、不良反应方面无明显差异（ P﹥0.05）。结论大剂量固尔苏(200 mg/kg )治疗极低出生体重儿呼吸窘迫综合征是安全的，且能更有效地改善肺氧合功能，减少辅助通气的应用。