不同剂量猪肺磷脂注射液治疗新生儿呼吸窘迫综合征疗效比较

摘要

Objective:To observe the effects of the different first doses of poractant alfa injection in the treatment of neonatal respiratory distress syndrome( NRDS) in premature infants. Methods:Eighty-one premature infants( gestational age < 37 weeks) with NRDS were divided into the high dose group(29 cases),medium dose group(25 cases) and low dose group(27 cases),and treated with 200,150 and 100 mg/kg poractant alfa injection combined with appropriate symptomatic support treatment,respectively. Results:The significant improvement of chest film,and levels of PaO2 and PaCO2 in high dose group was significantly higher that in medium and low dose groups(P<0. 01),and the average mechanical ventilation time and oxygen cure time in high dose group were lower than those in medium and low dose groups(P<0. 05 to P<0. 01). The differences of the total incidence rates of patent ductus arteriosus,severe infection,intracranial hemorrhage,death and giving up treatment between three groups were statistically significant(P <0. 01),and which in high dose group,medium dose group and low dose group gradually decreased in turn. Conclusions:The 200 mg/kg poractant alfa injection in the treatment of NRDS in premature infants can significantly improve the chest film and arterial blood gas analysis, shorten the mechanical ventilation time and oxygen therapy time,and is worthy of promotion in clinic.%目的:观察首次不同剂量猪肺磷脂注射液对新生儿呼吸窘迫综合征(NRDS)早产儿的临床治疗效果.方法:对胎龄小于37周、诊断为NRDS的81例早产儿,按猪肺磷脂注射液应用剂量分为大剂量组(29例)、中剂量组(25例)和小剂量组(27例),分别给予200、150、100 mg/kg治疗及适当的对症支持治疗.结果:大剂量组胸片显著改善率及动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)水平明显高于中剂量组及小剂量组(P<0.01),平均机械通气时间、氧疗时间均低于中等剂量组及小剂量组(P<0.05～P<0.01).3组动脉导管未闭、重症感染、颅内出血、死亡及放弃治疗的总发生率差异均有统计学意义(P<0.01),大剂量组发生率最低,其次是中剂量组和小剂量组.结论:对于确诊为NRDS的早产儿,首次给予猪肺磷脂注射液治疗剂量200 mg/kg可显著改善患儿胸片及动脉血气分析结果,缩短早产儿机械通气时间及氧疗时间,值得临床推广.