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目的探讨肺表面活性物质在救治新生儿呼吸窘迫综合征后的转归情况。方法收集2009年2月2010年1月期间本院新生儿监护病房43例胎龄<35周患新生儿呼吸窘迫综合征的早产儿临床资料,将43例早产儿随机分为两组:1组(应用肺表面活性物质)、2组(不应用肺表面活性物质),比较两组早产儿的并发症及转归情况。结果 22例应用肺表面活性物质治疗的新生儿呼吸窘迫综合征患儿,脑室内出血(intraventricular hemorrhage,IVH)1例,支气管肺发育不良(bronchopulmonary dysplasia,BPD)3例,早产儿视网膜病(retinopathy of prematurity,ROP)2例,死亡例数2例,住院天数(11.0±15.0)天。21例未应用肺表面活性物质治疗的新生儿呼吸窘迫综合征患儿,IVH3例,BPD4例,ROP5例,死亡例数11例,住院天数(22.0±17.0)天。两组比较并发IVH、ROP及死亡例数,住院天数有显著差异(P<0.05),BPD1组有下降,差异无统计学意义。结论有新生儿呼吸窘迫综合征高危因素的早产儿出生后应密切监护,早期应用肺表面活性物质,可以减少并发症,提高健康成活率,但对BPD的防治作用有限。
Objective To investigate the outcome of pulmonary surfactant in the treatment of neonatal respiratory distress syndrome. Methods The clinical data of 43 preterm infants with neonatal respiratory distress syndrome at gestational age <35 weeks were collected from February 2009 to January 2010 in our hospital. 43 premature infants were randomly divided into two groups: group 1 (Application of pulmonary surfactant) and 2 (no application of pulmonary surfactant) comparisons of complications and outcome in both groups of preterm infants. Results Among 22 neonates with respiratory distress syndrome treated with pulmonary surfactant, 1 case had intraventricular hemorrhage (IVH), 3 had bronchopulmonary dysplasia (BPD), 3 had retinopathy of prematurity There were 2 cases of prematurity (ROP), 2 cases of death and 11.0 ± 15.0 days of hospitalization. 21 cases of neonatal respiratory distress syndrome without pulmonary surfactant treatment, 3 cases of IVH, 4 cases of BPD, 5 cases of ROP, 11 cases of death and hospitalization days (22.0 ± 17.0) days. There were significant differences in IVH, ROP, death and hospitalization days between the two groups (P <0.05), BPD1 group and no significant difference between the two groups. Conclusion Preterm infants with high risk of neonatal respiratory distress syndrome should be closely monitored after birth. Early application of pulmonary surfactant can reduce the complication and improve the healthy survival rate, but it has a limited effect on the prevention and treatment of BPD.