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目的通过回顾性总结分析本院新生儿呼吸窘迫综合征(NRDS)的救治情况,探讨肺表面活性物质(PS)挽救性治疗策略的疗效。方法回顾性分析46例NRDS患儿的临床资料。男33例,女13例;年龄40min～6h;胎龄32+5周;出生体质量(2022±779)g。按照是否应用PS分为2组:使用PS组(n=32)与未使用PS组(n=14)。比较2组呼吸支持时间和吸入吸氧体积分数(FiO2)、氧疗时间、住院天数、治愈率、病死率、并发症等情况。结果使用PS组和未使用PS组患儿的呼吸支持时间[17.5h(0～120.0h)vs0.5h(0.5～24.0h),P<0.05]、FiO2[32.5%(22%～90%)vs85.0%(40%～100%),P<0.05]比较有统计学差异。而2组氧疗时间[24h(2～240h)vs48h(2～408h),P>0.05]比较未见统计学差异。但与使用PS组比较,住院天数明显缩短。2组患儿并发症发生情况无明显差异。使用PS组患儿的治愈率为81.3%、病死率为18.8%,未使用PS组NRDS患儿的治愈率为35.7%、病死率为64.3%,2组治愈率比较差异有统计学意义(P<0.05)。结论挽救性应用PS可以显著提高NRDS的治愈率,降低病死率。
Objective To retrospectively analyze the treatment of neonatal respiratory distress syndrome (NRDS) in our hospital and investigate the efficacy of salvage therapy of pulmonary surfactant (PS). Methods The clinical data of 46 children with NRDS were retrospectively analyzed. 33 males and 13 females; aged 40min ~ 6h; gestational age 32 + 5 weeks; birth weight (2022 ± 779) g. The PS group (n = 32) and the unused PS group (n = 14) were used according to whether or not PS was used. The respiratory support time, FiO2, duration of oxygen therapy, hospitalization days, cure rate, case fatality rate and complication were compared between the two groups. Results The respiratory support time (17.5h (0-120.0h) vs 0.5h (0.5-24.0h), P <0.05], FiO2 [32.5% (22% -90% vs85.0% (40% ~ 100%), P <0.05] compared with a statistically significant difference. However, there was no significant difference between the two groups in the duration of oxygen therapy [24h (2 ~ 240h) vs 48h (2 ~ 408h), P> 0.05]. However, compared with the use of PS group, the hospitalization days were significantly shorter. There was no significant difference in the incidence of complications between the two groups. The cure rate of children with PS group was 81.3% and the case fatality rate was 18.8%. The cure rate of NRDS children without PS group was 35.7% and the case fatality rate was 64.3%. There was significant difference between the two groups (P <0.05). Conclusions Salvage PS can significantly improve the cure rate and reduce the mortality of NRDS.