【摘要】 目的　评价肺表面活性制剂 (PS)在治疗新生儿呼吸窘迫综合征 (NRDS)的疗效和安全性。方法　对 4个医院的 42例NRDS患儿用curosurf (PS的一种 )治疗 ,观察治疗前后患儿肺功能和肺泡充气程度的变化及早产儿部分常见并发症的发生率。结果　用药后 30min患儿PaO2 和动脉 肺泡氧分压比值 (a/APO2 )明显上升 ,分别从 (44± 14)mmHg (1mmHg =0 .133kPa)上升至 (10 2± 5 9)mmHg和从 0 .11± 0 .0 5上升至 0 .2 8± 0 .18。用药后 1h、6h、12h、2 4h、3d和 10d的PaO2 和a/APO2 仍在较高水平 ,与用药前比较 ,差异均有非常显著意义 (P均 <0 .0 1)。用药后 30min ,患儿PaCO2 从用药前的 (5 4± 17)mmHg下降至 (45± 13)mmHg (P <0 .0 5 )。用药后 12h ,胸部X线片显示 ,患儿肺野透亮度明显改善 ,与用药前比较 ,差异有非常显著意义。用药后患儿颅内出血、气胸、动脉导管开放和肺炎等并发症的发生率分别为 2 8%、7%、35 %和 79%。结论　curosurf治疗能快速、安全、有效地改善NRDS患儿的肺功能和肺泡充气程度。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of pulmonary surfactant (PS) in the replacement therapy for neonatal respiratory distress syndrome (NRDS). Methods Forty-two NRDS infants from four hospitals in Beijing were treated with curosurf which is one of the PS. The changes of the lung function and lung aeration after the therapy and some common complications in premature infants were observed. Results Thirty minutes after the administration of curosurf, PaO 2 significantly increased from (44±14) mm Hg to (102±59) mm Hg, a/APO 2 from 0.11±0.05 to 0.28±0.18. PaO 2 and a/APO 2 remained higher levels until 10 days after the administration and were significantly different from the levels before the treatment ( P <0.01). After 30 minutes of the administration, PaCO 2 decreased from (54±17) mm Hg to (45±13) mm Hg ( P <0.05). After 12 hours of the administration, chest X-ray showed a significant improvement in lung aeration. After 24 hours, the mechanical ventilation frequency decreased significantly from (48±8) times/min to (42±12) times/min, the peak inspiratory pressure decreased from (22.2±3.6) mm Hg to (19.4±2.8) mm Hg, and the mean airway pressure from (11.8±2.0) mm Hg to (9.9±2.2) mm Hg. The incidences of the intracranial hemorrhage, pneumothorax, patent ductus arteriousus and pneumonia were 28%, 7%, 35% and 79%, respectively. Conclusion Curosurf could rapidly and effectively improve the lung function and lung aeration in NRDS infants.更多还原