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目的 探讨预防性应用吲哚美辛减少肺表面活性物质治疗或预防新生儿呼吸窘迫综合征的合并症。 方法 临床诊断为新生儿呼吸窘迫综合征的早产儿 40 例,用肺表面活性物质(固尔苏)治疗,按有无用吲哚美辛预防分为A1 组22例与B1 组18例。胎龄< 32 周未发生新生儿呼吸窘迫综合征的早产儿 37 例,用肺表面活性物质预防,按有无用吲哚美辛预防分为 A2 组 24 例与 B2 组13例。分别比较A1 与B1 组、A2 与B2 组的辅助通气(含鼻塞CPAP和机械通气)时间和发生动脉导管未闭、肺出血、脑室内出血及死亡情况分布并做统计学分析。 结果 A1 与B1 两组辅助通气时间分别为 (94.9 ± 61.5) h、(105.8 ± 103.0) h,差异无统计学意义(P>0.05);发生动脉导管未闭例数分别为8、14例,差异有统计学意义(P<0.05);发生肺出血、脑室内出血例数的差异无统计学意义(P>0.05);死亡例数≤3 d分别为0和3例,差异有统计学意义(P<0.05),>3 d各为 3 例,差异无统计学意义(P>0.05)。A2 与B2 两组辅助通气时间分别为 (24.0 ± 20.8) h、(44.0± 25.9) h,发生动脉导管未闭例数分别为2和5例,差异均有统计学意义(P<0.05);发生肺出血例数的差异无统计学意义(P>0.05);发生脑室内出血例数较少,死亡例数≤3 d分别为0和1 例,>3 d各为 1 例,未做统计学分析。
Objective To investigate the prophylactic use of indomethacin in the treatment of pulmonary surfactant or the prevention of neonatal respiratory distress syndrome. Methods 40 cases of premature infants with respiratory distress syndrome were diagnosed as neonatal respiratory distress syndrome. They were treated with pulmonary surfactant (Curetosine) and divided into A1 group (22 cases) and B1 group (18 cases) by indomethacin prevention. Thirty-seven preterm infants with gestational age <32 weeks without neonatal respiratory distress syndrome were treated with pulmonary surfactant and 24 with A2 and 13 with B2 as prophylaxis with indomethacin. The distribution of auxiliary ventilation (including nasal CPAP and mechanical ventilation) and the occurrence of patent ductus arteriosus, pulmonary hemorrhage, intraventricular hemorrhage and death in groups A1 and B1, A2 and B2 were compared respectively and statistically analyzed. Results The durations of assisted ventilation between A1 and B1 were (94.9 ± 61.5) h and (105.8 ± 103.0) h, respectively, with no significant difference (P> 0.05). The number of cases with patent ductus arteriosus was 8 and 14, (P <0.05). There was no significant difference in the number of pulmonary hemorrhage and intraventricular hemorrhage between the two groups (P> 0.05). The number of death cases ≤3 d were 0 and 3 respectively, with statistical significance (P < P <0.05), 3 cases> 3 days, the difference was not statistically significant (P> 0.05). The durations of assisted ventilation in group A2 and group B2 were (24.0 ± 20.8) h and (44.0 ± 25.9) h, respectively. There were 2 and 5 cases of patent ductus arteriosus, the differences were statistically significant (P <0.05). There were no significant differences in the number of cases of pulmonary hemorrhage (P> 0.05); fewer cases of intraventricular hemorrhage occurred, the number of deaths ≤3d were 0 and 1, respectively,> 1 and 3 d respectively, without statistics analysis.