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目的:探讨早产儿生后6 h内使用牛肺表面活性剂(PS)预防新生儿呼吸窘迫综合征(NRDS)的疗效。方法:我院出生的76例胎龄28～32周的早产儿随机分为两组,预防组38例给予气管内注入40～100 mg/kg牛肺表面活性剂与未用PS的对照组38例进行前瞻性临床研究,比较两组NRDS的发生情况。结果:预防组发生NRDS 5例,对照组发生NRDS 17例,两组比较差异有统计学意义(P<0.05)。预防组吸氧天数(9.2±6.1)d、呼吸机使用天数(6.5±4.9)d及住院天数(29.3±7.8)d,较对照组(16.7±6.4)d、(9.8±7.0)d、(37.4±7.2)d明显缩短,差异有统计学意义(P<0.05)。预防组肺部并发症如肺部感染及支气管肺发育不良较对照组明显减少,两组比较差异有统计学意义(P<0.05)。结论:早产儿预防性使用牛肺表面活性剂能减少NRDS的发生率,减少呼吸机的使用,减少肺部并发症发生,改善早产儿预后。
Objective: To investigate the efficacy of using bovine pulmonary surfactant (PS) in the prevention of neonatal respiratory distress syndrome (NRDS) within 6 h after birth. Methods: A total of 76 preterm infants born 28 to 32 weeks old in our hospital were randomly divided into two groups. In the prophylaxis group, 38 cases were given intratracheal instillation of 40 ~ 100 mg / kg bovine pulmonary surfactant and control group without PS A prospective clinical study was conducted to compare the incidence of NRDS in both groups. Results: There were 5 cases of NRDS in prevention group and 17 cases of NRDS in control group. There was significant difference between the two groups (P <0.05). Compared with control group (16.7 ± 6.4) days, (9.8 ± 7.0) days, (9.2 ± 6.1) days, ventilator use days (6.5 ± 4.9) days and hospital stay days (29.3 ± 7.8 days) 37.4 ± 7.2) d significantly shortened, the difference was statistically significant (P <0.05). Prevention group of lung complications such as lung infection and bronchopulmonary dysplasia significantly reduced compared with the control group, the difference between the two groups was statistically significant (P <0.05). Conclusion: Preventive use of bovine pulmonary surfactant in preterm infants can reduce the incidence of NRDS, reduce the use of ventilator, reduce the incidence of pulmonary complications and improve the prognosis of preterm infants.