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目的 呼吸窘迫综合征(RDS)是早产儿发病和死亡的重要原因.RDS主要由肺表面活性物质缺乏所致.该研究调查了表面活性物质治疗在减少早产儿死亡率中的作用,并评估了表面活性物质疗效与一些RDS相关危险因素的关系.方法 通过简单抽样抽取符合入选要求的89例RDS早产儿,他们均来自于Shabeed Beheshti医院新生儿重症监护室.生后48 h内给予表面活性物质治疗(100 mg/kg).结果 89例得到表面活性物质治疗的RDS早产儿中,34例(38.2%)幸存,55例死亡.其中胎龄大于32周,表面活性物质治疗开始于生后24 h内,1,5分钟Apgar评分大于7/10分,或出生体重大于1 500 g者治疗效果较好,存活率分别为47.5%,43.3%,48.1%,52.5%.表面活性物质治疗后母亲孕前经过激素治疗的RDS早产儿的存活率(41.7%)显著高于那些母亲孕前未经激素治疗者(34.2%)(P<0.05).结论 表面活性物质替代治疗新生儿RDS应尽可能早地进行,能减少38.2%的死亡率.新生儿胎龄、出生体重、Apgar评分、表面活性物质治疗开始时间及母亲孕期是否经激素治疗等均可影响表面活性物质替代治疗的疗效.“,”Objective Respiratory distress syndrome (RDS) is a major cause of morbidity and mortality in preterm neonates. Pulmonary suffaetant deficiency is the primary cause of RDS. The purpose of this study was to determine the effect of surfactant therapy in reduction of the mortality rate in premature neonates with RDS and to assess the relationship between the efficacy of surfactant therapy and some risk factors associated with RDS. Methods This study comprised 89 premature neonates with signs of RDS. The neonates were selected by simple sampling from those admitted to the Neonatal Intensive Care Unit (NICU) of Shahecd Beheshti Hospital. The eligible neonates received surfactant replacement therapy (100 mg/kg) during 48 hours after birth. Results Overall, 34 (38.2%) out of 89 neonates who received surfactant survived. The higher efficacy of surfactant replacement therapy was observed in neonates with gestational age of more than 32 weeks (47.5%), in those who received the lust dose of surfactant during the first 24 hours of life (43.3%), in those with an Apgar score of more than 7/10 at 1 and 5 rain (48.1%), and in those with a birth weight ofmore than 1 500 g (52.5%). The neonates whose mother received steroid therapy before labor had higher reduction in mortality after suffaetant therapy (41.7% with steroid vs 34.2% without steroid; P<0.05). Conclusions Surfactant replacement therapy in neonatal RDS should be. started as soon as possible after birth. It could reduce the mortality rate from RDS by 38.2%. The efficacy of surfaetant therapy for neonatal RDS may be associated with gestational age, Apgar score, birth weight, starting time of sudaetant therapy and maternal steroid therapy.