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目的比较猪肺表面活性物质与牛肺表面活性物质治疗早产儿呼吸窘迫综合征(RDS)的疗效。方法选择本院新生儿科2011年1月至2012年6月收治、应用肺表面活性物质和持续气道正压通气(CPAP)的RDS患儿进行回顾性分析,根据用药情况分为猪肺表面活性物质组(固尔苏组)和牛肺表面活性物质组(珂立苏组),两组诊断RDS后均予以气管插管给药。比较两组应用肺表面活性物质前后血气指标、CPAP时间、氧疗时间、住院时间、并发症及死亡情况。结果固尔苏组36例,珂立苏组32例,两组患儿应用肺表面活性物质后6 h、24 h的PaO2、PaCO2和pH值与用药前相比均明显改善(P<0.05),两组间各时间点比较差异无统计学意义(P>0.05)。固尔苏组应用CPAP时间短于珂立苏组[(98.8±15.2)h比(113.6±13.0)h,P<0.05]。两组患儿用氧时间、住院时间、并发症(颅内出血、肺气漏、呼吸机相关肺炎、支气管肺发育不良、动脉导管未闭、早产儿视网膜病、新生儿坏死性小肠结肠炎)发生率及死亡率差异均无统计学意义(P>0.05)。结论猪肺表面活性物质与牛肺表面活性物质治疗早产儿RDS疗效及安全性相似,使用猪肺表面活性物质的患儿CPAP时间缩短,临床上可综合考虑酌情选用。
Objective To compare the efficacy of porcine pulmonary surfactant with bovine pulmonary surfactant in the treatment of respiratory distress syndrome (RDS) in preterm infants. Methods The neonates admitted to our hospital from January 2011 to June 2012 were retrospectively analyzed for pulmonary surfactant and continuous positive airway pressure (CPAP) (Cortisone group) and bovine pulmonary surfactant group (Cristobuss group). Both groups were given tracheal intubation after diagnosis of RDS. Blood gas index, CPAP time, oxygen therapy time, hospitalization time, complications and death before and after pulmonary surfactant application were compared between the two groups. Results 36 cases of Guer Su group and 32 cases of Ke Li Su group, PaO2, PaCO2 and pH value of 6 h and 24 h after pulmonary surfactant application in both groups were significantly improved (P <0.05) There was no significant difference between the two groups at all time points (P> 0.05). The use of CPAP in Guer Su-Su group was shorter than that of Ke-Li Su (98.8 ± 15.2 h vs 113.6 ± 13.0 h, P <0.05). Two groups of children with oxygen time, hospital stay, complications (intracranial hemorrhage, pulmonary air leaks, ventilator-associated pneumonia, bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity, neonatal necrotizing enterocolitis) occurred There was no significant difference in rates and mortality (P> 0.05). Conclusion Porcine pulmonary surfactant is similar to bovine pulmonary surfactant in the treatment of premature infants with RDS. The duration of CPAP in children with porcine pulmonary surfactant is shortened and can be considered clinically as appropriate.