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目的比较不同剂量牛肺表面活性物质(PS)治疗晚期早产儿新生儿呼吸窘迫综合征(RDS)的疗效。方法选择2012年7月至2013年6月淄博市妇幼保健院新生儿重症监护中心收治的晚期早产儿RDS患儿,随机分为2组,均予国产PS(珂立苏),首剂大剂量组70 mg/kg,小剂量组40 mg/kg。比较两组血气指标、氧合指数、呼吸机参数、用药后机械通气时间、总用氧时间、肺部X线改变及常见并发症的发生率等。结果大剂量组和小剂量组各纳入16例,两组患儿应用PS 24 h后,PO2、PCO2、氧合指数及X线胸片表现均较使用前好转,差异有统计学意义(P<0.05)。两组相比,大剂量组PCO2(mm Hg)和氧合指数均低于小剂量组[(41.2±4.2)比(44.9±5.4),(4.8±0.8)比(7.4±2.0)],X线评分(分)优于小剂量组[(1.0±0.3)比(1.4±0.6)],应用PS次数、肺炎发生率、氧疗时间、机械通气时间、住院时间均低于小剂量组,差异有统计学意义(P均<0.05)。两组气胸发生率和治愈率差异无统计学意义(P>0.05)。结论对于晚期早产儿RDS给予珂立苏治疗时,剂量应尽量满足70 mg/kg。
Objective To compare the efficacy of different doses of bovine pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (RDS) in advanced preterm infants. Methods From July 2012 to June 2013, children with preterm infants with RDS who were admitted to the neonatal intensive care center of Zibo MCH hospital were randomly divided into two groups, all of which were given domestic PS (high dose) Group 70 mg / kg, low-dose group 40 mg / kg. Blood gas index, oxygenation index, ventilator parameters, mechanical ventilation time, total oxygen time, pulmonary X-ray changes and the incidence of common complications were compared between the two groups. Results The high-dose group and the low-dose group were enrolled in each of 16 cases. After application of PS for 24 h, PO2, PCO2, oxygenation index and X-ray showed better in both groups (P < 0.05). The PCO2 (mm Hg) and oxygenation index of the high-dose group were significantly lower than those of the low-dose group [(41.2 ± 4.2) vs (44.9 ± 5.4) vs (4.8 ± 0.8) vs (7.4 ± 2.0) Line score (score) was better than the low-dose group [(1.0 ± 0.3) vs (1.4 ± 0.6)]. The frequency of PS, the incidence of pneumonia, oxygen therapy time, mechanical ventilation time and hospital stay were all lower than those of the low-dose group There was statistical significance (all P <0.05). There was no significant difference in the incidence of pneumothorax and cure between the two groups (P> 0.05). Conclusions The dose of risperidone should be as high as 70 mg / kg for RDS given to preterm infants with advanced preterm infants.