标题：机械通气下不同时段使用猪肺表面活性物质治疗

      作者：早产儿呼吸窘迫综合征的临床分析
    黄国日，潘 革
（广西医科大学第三附属医院 南宁市第二人民医院，广西 南宁 530031）

      卷次： 2012年23卷11期

      【摘要】 目的 观察不同时间给予猪肺表面活性物质（固尔苏，PS）治疗早产儿呼吸窘迫综合征（NRDS）的
效果，在确定固尔苏使用的最佳时间。方法 将 145例确诊为NRDS的早产儿随机分成三组，在采用机械通气
下，早期用药组49例在生后0~6 h内用药，中期用药组48例在生后6~12 h内用药，晚期用药组48例在生后12~24
h内用药。观察和比较治疗前后患儿的临床表现、动脉血气、呼吸机参数等指标。结果 应用PS后患儿临床症
状均有明显改善，动脉血氧分压（PaO2）、pH值均明显升高，而二氧化碳分压（PaCO2）值明显下降，差异有统计学
意义（P＜0.05）；应用PS后患儿机械通气参数吸入氧浓度（FiO2）、最大吸气峰压（PIP）、平均气道压(MAP)、呼气终
末气道正压（PEEP）等较用药前均明显下调（P＜0.05）。早期用药组患儿上述参数的改善明显优于中晚期用药组
（P＜0.05）。结论 肺表面活性物质联合机械通气能迅速有效地治疗新生儿呼吸窘迫综合征，临床症状、机械通
气等均有明显改善；早期用药组比中晚期用药组患儿呼吸功能改善效果更佳；住院日、住院费用少于中晚期用药
组；尽早应用PS治疗NRDS可取得更佳的疗效。

      【关键词】 机械通气；肺表面活性物质；早产儿；呼吸窘迫综合征

      【中图分类号】 R722 【文献标识码】 A 【文章编号】 1003—6350（2012）11—009—03<

br>Clinical analysis of pig pulmonary surfactant in the treatment of respiratory distress syndrome in preterm
infants at different times under mechanical ventilation.
HUANG Guo-ri, PAN Ge. The Third Affiliated Hospital of
Guangxi Medical University (The Second People's Hospital of Nanning City), Nanning 530 031, Guangxi, CHINA

【Abstract】 Objective To observe the clinical efficacy of pig pulmonary surfactant (Curosurf, PS) in the
treatment of preterm infants with respiratory distress syndrome (RDS) at different times under mechanical ventilation,
and to determine the premium time to use PS. Methods One hundred and forty-five premature infants diagnosed as
RDS were randomly divided into three groups. The early treatment group (n=49) received PS in 0~6 h after birth, the
intermediate treatment group (n=48) received PS in 6~12 h after birth, and the late treatment group (n=48) received PS
in 12~24 h after birth. The clinical manifestation, arterial blood gas, respiratory ventilation parameters were observed
and compared. Results After the application of PS, the arterial oxygen tension (PaO2), PH values were significantly
increased, while the carbon dioxide partial pressure (PaCO2) were significantly decreased (P<0.05); The inspired oxy-
gen concentration (FiO2), maximum inspiratory pressure (PIP), mean arterial pressure (MAP), and terminal expiratory
pressure (PEEP) after treatment were significantly lower than those before treatment (P<0.05). The improvements of
the parameters in children in the early treatment group were more significant than those in the intermediate and late
treatment group (P<0.05). Conclusion Pulmonary surfactant with mechanical ventilation is quite effective for neona-
tal respiratory distress syndrome. Better clinical results can be achieved to treat the disease early.

      【Key words】 Mechanical ventilation; Pulmonary surfactant; Preterm infants; Respiratory distress syndrome
·论 著·