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目的探讨牛肺表面活性物质(PS)治疗新生儿肺透明膜病(HMD)的有效性和安全性。方法根据首诊医生给药剂量的不同,89例HMD患儿分为两组:A组,34例,给予PS(94.86±14.94)mg/kg;B组,55例,给予PS(55.26±10.70)mg/kg。比较两组患儿的临床疗效。结果两组用药后的相关观察指标均较用药前改善(P<0.05或P<0.01)。与B组相比,A组用药后吸氧浓度(FiO2)降低(P<0.05),动脉血氧分压(PaO2)上升(P<0.05),氧疗时间、动脉血氧饱和度(SaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数(OI)和动脉/肺泡氧分压比值(a/APO2)均有所改善(P>0.05)。两组治愈好转率、病死率以及并发症发生率无统计学差异(P>0.05)。结论早期大剂量牛PS治疗能有效改善HMD患儿的氧合和通气效率,不增加并发症及死亡风险。
Objective To investigate the efficacy and safety of bovine pulmonary surfactant (PS) in the treatment of neonatal hyaline membrane disease (HMD). Methods According to the dose of first-time doctors, 89 children with HMD were divided into two groups: group A, 34 cases, giving PS (94.86 ± 14.94) mg / kg; group B, 55 cases giving PS (55.26 ± 10.70 ) mg / kg. The clinical efficacy of the two groups was compared. Results After treatment, the relevant observation indexes were improved compared with before treatment (P <0.05 or P <0.01). Compared with group B, FiO2 decreased (P <0.05), PaO2 increased (P <0.05), oxygen therapy time, arterial oxygen saturation (SaO2) (PaCO2), oxygenation index (OI) and arterial alveolar oxygen ratio (a / APO2) were improved (P> 0.05). There was no significant difference in the cure rate, fatality rate and complication between the two groups (P> 0.05). Conclusion Early high-dose bovine PS treatment can effectively improve oxygenation and ventilation efficiency in children with HMD without increasing the risk of complications and death.