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不同剂量牛肺表面活性物质治疗早产儿呼吸窘迫综合征的临床研究

Different Doses of Bovine Pulmonary Surfactant in the Treatment of Premature Infants with Respiratory Distress Syndrome

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【作者】 李文孙爱荣姜红赵日明许平刘建红张成元牛世平江丽邱丙平姚国张志明陈为兵刘秀香王瑜

【Author】 Li Wen;Sun Airong;Jiang Hong;Zhao Riming;Xu Ping;Liu Jianhong;Zhang Chenyuan;Niu Shiping;Jiang Li;Qiu Bingping;Yao Guo;Zhang Zhiming;Chen Weibing;Liu Xiuxiang;Wang Yu;Qilu Hospital,Shandong University;Maternal and Child Health Care Hospital of Linyi City;Affiliated Hospital of Medical College of Qingdao University;People’s Hospital of Juxian County;People’s Hospital of Liaocheng City;Children’s Hospital of Ji’nan City;Maternal and Child Health Care Hospital of Weifang City;Maternal and Child Health Hospital of Zibo City;People’s Hospital of Dezhou City;Central People’s Hospital of Tengzhou City;Central Hospital of Tai’an City;Central Hospital of Shengli Oil Field;People’s Hospital of Rizhao;Affiliated Hospital of Binzhou Medical College;Affiliated Hospital of Jining Medical College;

【机构】 山东大学齐鲁医院临沂市妇幼保健院青岛大学医学院附属医院莒县人民医院聊城市人民医院济南市儿童医院潍坊市妇幼保健院淄博市妇幼保健院德州市人民医院滕州市中心人民医院泰安市中心医院胜利油田中心医院日照市人民医院滨州医学院附属医院济宁医学院附属医院

【摘要】 目的:探讨不同剂量牛肺表面活性物质(珂立苏)治疗早产儿呼吸窘迫综合征的临床疗效。方法:选取我院2012年9月至2014年9月收治的227例新生儿呼吸窘迫综合征(NRDS)早产儿作为研究对象,均给予牛肺表面活性物质治疗,将患儿随机分为标准剂量组(70 mg/kg)117例、高剂量组(100 mg/kg)110例,比较两组用药后1 h、6 h、12 h、24 h、48 h呼吸机参数、血气指标、通气时间和并发症发生率。结果:高剂量组用药6 h、12 h、24 h、48 h平均气道压(MAP)低于标准剂量组(P<0.05);高剂量组用药1 h、6 h、12 h、24 h、48 h后吸入氧浓度(Fi O2)低于标准剂量组(P<0.05)。高剂量组用药1 h、6 h、24 h、48 h动脉血二氧化碳分压(PCO2)均低于标准剂量组,动脉血氧分压(PO2)高于标准剂量组(P<0.05);高剂量组用药6 h、12 h、24 h后氧合指数(OI)均低于标准剂量组(P<0.05)。高剂量组新生儿肺表面活性物质(PS)用药次数、通气时间均少于标准剂量组(P<0.05)。高剂量组并发症发生率为8.18%,低于标准剂量组的18.80%(P<0.05)。结论:牛肺表面活性物质治疗NRDS时,首剂用药剂量应满足100 mg/kg,安全有效。

【Abstract】 Objective: To explore the effects of different doses of bovine pulmonary surfactant(Calsurf) in the treatment of premature infants with respiratory distress syndrome.Methods: Two hundreds and twenty-seven premature infants with neonatal respiratory distress syndrome(NRDS) were selected as the study subjects.All children were treated in our hospital from September 2012 to September2014.All children were randomly divided into standard dose group(117 cases) and high dose group(110 cases),standard dose group was treated with bovine pulmonary surfactant 70 mg / kg,high dose group was treated with bovine pulmonary surfactant 100 mg / kg.The changes of ventilator parameters,blood gas indexes at the 1st,6th,12 th,24thand 48 thhour after drug use,duration of ventilation and incidence of complications were compared between the two groups.Results: After 6 hours,12 hours,24 hours and 48 hours,the mean arterial pressure(MAP) of high dose group were significantly lower than those of standard dose group(P < 0.05).After 1 hour,6hours,12 hours,24 hours and 48 hours,oxygen concentration(Fi O2) of high dose group were significantly lower than those of standard dose group(P<0.05).After 1 hour,6 hours,24 hours and 48 hours,arterial partial pressure of carbon dioxide(PCO2) of high dose group were lower than those of standard dose group while arterial partial pressure of oxygen(PO2) were higher than those of standard dose group(P<0.05).After 6 hour,12 hours and 24 hours,OI of high dose group were significantly lower than those of standard dose group(P<0.05).In the high dose group,the time of using pulmonary surfactant(PS) and duration of ventilation were significantly less than those in standard dose group(P<0.05).The incidence rate of complications in high dose group(8.18%) was significantly lower than that in standard dose group(18.80%,P < 0.05).Conclusion: When using Calsurf in the treatment of premature infants with NRDS,the first dose should be 100 mg / kg.Thus,the treatment is safe and effective.

  • 【文献出处】 儿科药学杂志 ,Journal of Pediatric Pharmacy , 编辑部邮箱 ,2016年12期
  • 【分类号】R722.6
  • 【被引频次】3
  • 【下载频次】96
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