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目的 观察肺表面活性剂 (PS)对新生儿呼吸窘迫综合征 (NRDS)疗效的影响因素。 方法 采用回顾性病例对比分析方法 ,对 42例经气管注入接受PS治疗的NRDS患儿 ,按PS治疗前 5min血气分析结果 ,分为 pH <7 2 5 (A)和 pH≥ 7 2 5 (B)组。观察两组PS治疗前后a/APO2 的变化。再将每一组分别按孕周和体重大小分为孕周 <3 1周和孕周≥ 3 1周组、体重≥1 75kg和体重≥ 1 75kg组。观察不同孕周和不同体重患儿接受PS治疗前后a/APO2 的变化。 结果 A、B两组患儿PS治疗前a/APO2 均无显著差异 ,PS治疗后 0 5、1、6、12h时 ,B组的a/APO2 均明显高于A组 ,差异有显著意义 (P均 <0 0 5 )。A组内孕周≥ 3 1周的患儿 ,PS治疗前a/APO2 明显低于孕周 <3 1周组 ,差异有显著意义 (P <0 0 5 ) ,PS治疗后各个观察时间 ,两组的a/APO2 均无显著差异。A组内体重≥ 1 75kg的患儿 ,PS治疗前a/APO2 明显低于体重 <1 75kg组 ,差异有显著意义 (P <0 0 5 ) ,PS治疗后各个观察时间 ,两组a/APO2 无显著差异。PS治疗前和治疗后 ,B组内不同孕周和不同体重患儿的a/APO2 均无显著差异。 结论 严重酸中毒可减弱PS对NRDS患儿的疗效
Objective To observe the effect of pulmonary surfactant (PS) on neonatal respiratory distress syndrome (NRDS). Methods A retrospective case-control study was conducted in 42 children with NRDS who were treated with PS by tracheal injection and divided into 5 groups according to the results of blood gas analysis 5 minutes before treatment: pH <7 2 5 (A) and pH ≥ 7 2 5 (B )group. The changes of a / APO2 in both groups before and after PS treatment were observed. Each group was divided into gestational age <31 weeks and gestational age> 31 weeks group, body weight ≥175kg and body weight ≥175kg group according to gestational age and body weight respectively. The changes of a / APO2 before and after PS treatment in children with different gestational weeks and different weights were observed. Results There was no significant difference in a / APO2 before and after PS treatment in both A and B groups. At 0, 5, 1, 6 and 12 hours after PS treatment, the a / APO2 of group B were significantly higher than that of group A P <0 05). In group A, the a / APO2 before PS treatment was significantly lower than that in gestational week <31 weeks in children with gestational age ≥31 weeks, and the difference was significant (P <0.05). PS, Group a / APO2 no significant difference. A group of children with body weight ≥ 1 75kg, PS before treatment, a / APO2 was significantly lower than the body weight <1 75kg group, the difference was significant (P <0 05), PS after treatment of each observation time, two groups a / APO2 No significant difference. Before and after PS treatment, there was no significant difference in a / APO2 among children with different gestational weeks and different body weights in group B. Conclusion Severe acidosis can attenuate the efficacy of PS in children with NRDS