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目的观察肺表面活性物质(PS)对新生儿肺透明膜病(HMD)的防治效果。方法选取2014年12月—2016年5月在榆林市第二医院儿科出生的有HMD发生风险的早产儿98例,采用随机数字表法分为对照组和观察组,每组49例。两组早产儿出生后均给予常规治疗,观察组患儿在此基础上加用猪肺磷脂注射液。比较两组早产儿用药前、用药后6 h及用药后24 h动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、pH值,临床转归情况,机械通气时间、住院时间,并发症发生率。结果方法与时间在PaO_2、PaCO_2及p H值无交互作用(P>0.05);方法在PaO_2、PaCO_2及p H值上主效应显著(P<0.05);时间在PaO_2、PaCO_2及p H值上主效应不显著(P>0.05);观察组早产儿用药后6 h及用药后24 h PaO_2、p H值高于对照组,PaCO_2低于对照组(P<0.05)。两组早产儿病死率比较,差异无统计学意义(P>0.05);观察组患儿机械通气率、HMD发生率均低于对照组(P<0.05)。观察组早产儿机械通气时间、住院时间均短于对照组(P<0.05)。观察组早产儿肺炎、颅内出血、肺出血发生率均低于对照组(P<0.05)。结论 PS能有效降低新生儿HMD发生风险并缩短机械通气时间,改善新生儿肺通气功能,且安全性较高。
Objective To observe the preventive and therapeutic effects of pulmonary surfactant (PS) on neonatal hyaline membrane disease (HMD). Methods A total of 98 premature infants with HMD who were born in the Second Hospital of Yulin City from December 2014 to May 2016 were randomly divided into control group and observation group with 49 cases in each group. Both groups of preterm infants were given conventional treatment after birth, the observation group of children on the basis of the addition of pulmonary phlebitis injection. The changes of PaO_2, PaCO_2, pH value, clinical outcome, mechanical ventilation time, length of hospital stay, Complication rate. Results The method and time had no interaction on PaO_2, PaCO_2 and p H (P> 0.05). The main effects of PaO_2, PaCO_2 and p H were significant (P <0.05); the time was on PaO_2, PaCO_2 and p H The main effect was not significant (P> 0.05). The PaO_2 and p H values of the preterm infants in the observation group were higher than those in the control group at 6 h and 24 h after the administration, and the PaCO 2 in the observation group was lower than that in the control group (P <0.05). There was no significant difference in mortality rate between two groups (P> 0.05). The mechanical ventilation rate and the incidence of HMD in the observation group were lower than those in the control group (P <0.05). The observation group, premature infants with mechanical ventilation time, hospitalization were shorter than the control group (P <0.05). The incidence of pneumonia, intracranial hemorrhage and pulmonary hemorrhage in the observation group was lower than that in the control group (P <0.05). Conclusion PS can effectively reduce the risk of neonatal HMD and shorten the duration of mechanical ventilation, improve neonatal pulmonary ventilation, and high safety.