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目的 探讨肺表面活性物质(PS)治疗早产儿呼吸窘迫综合征(RDS)是否能改善其临床经过、降低病死率。方法 诊断为RDS且胸片在Ⅱ级或Ⅱ级以上的早产儿27例,按时间顺序分组,1997年11月～1998年10月14例作为对照组,给以机械通气;1998年11月～1999年12月13例作为治疗组,气管内滴注PS,每次100mg/kg,必要时6～12h后按原剂量重复给药,同时给予机械通气。分别在治疗前后测定动脉氧分压(PaO_2)、吸入氧浓度(FiO_2)、平均气道压(MAP)、拍胸片。结果 治疗组于治疗后30min、6h、24h,PaO_2显著高于对照组,FiO_2、MAP显著低于对照组;胸片除2例重复给药者外,其余11例均于6h后症状即见改善,24h明显改善;存活者机械通气时间短,患儿出生0～3d的死亡率下降,与对照组比较差异有显著性。结论 PS治疗早产儿RDS可以迅速提高PaO_2,降低呼吸机参数,减少应用呼吸机时间,降低出生0～3d的病死率。
Objective To investigate if pulmonary surfactant (PS) treatment of premature infants with respiratory distress syndrome (RDS) can improve its clinical course and reduce the mortality. Methods The diagnosis of RDS and chest radiograph in grade Ⅱ or Ⅱ above 27 cases of preterm children, chronological grouping, November 1997 ~ October 1998 14 cases as a control group, given mechanical ventilation; November 1998 ~ December 1999 December as a treatment group, tracheal instillation of PS, each 100mg / kg, if necessary, 6 ~ 12h after the original dose repeated administration, given mechanical ventilation. The arterial oxygen pressure (PaO_2), inspired oxygen concentration (FiO_2), mean airway pressure (MAP) and chest radiograph were measured before and after treatment. Results In the treatment group, the PaO_2 values at 30min, 6h and 24h after treatment were significantly higher than those in the control group, while FiO_2 and MAP were significantly lower than those in the control group. In the other two cases, the remaining 11 cases showed improvement after 6 hours , 24h significantly improved; survival time of mechanical ventilation is short, the mortality of children born 0 ~ 3d decreased, compared with the control group, the difference was significant. Conclusion PS treatment of RDS in preterm infants can rapidly increase PaO_2, reduce the ventilator parameters, reduce the use of ventilator time, and reduce the mortality of 0 ~ 3d at birth.