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目的探讨肺表面活性物质(PS)固尔苏在治疗不同程度早产儿肺透明膜病(HMD)中的临床应用。方法对150例HMD患儿临床资料和疗效进行分析,按临床症状和胸部X线结果 ,分轻、中度HMD组(Ⅰ、Ⅱ级)86例(CPAP+PS治疗35例,CPAP治疗51例)和重度HMD组(Ⅲ、Ⅳ级)64例(机械通气+PS治疗44例,机械通气20例),比较不同程度HMD患儿联用PS与未使用PS治疗者治疗效果及并发症情况。结果总体治愈率75.3%,不同程度使用PS的HMD患儿治愈率均高于对照组(单纯CPAP或机械通气);轻、中度HMD组使用CPAP+PS治疗的HMD转为机械通气例数明显少于CPAP治疗患儿,差异有统计学意义(χ2=5.447,P<0.05)。PS联合机械通气的重度HMD组患儿并发症的发生率较单纯机械通气降低(P<0.05)。结论联合应用PS治疗HMD患儿比单纯应用CPAP或机械通气有显著疗效,可提高治愈率。
Objective To investigate the clinical application of pulmonary surfactant (PS) Guer Su Su in the treatment of hyaline membrane disease (HMD) in different degree. Methods Clinical data and curative effect of 150 cases of HMD children were analyzed. According to clinical symptoms and chest X-ray findings, 86 cases of mild and moderate HMD group (Ⅰ, Ⅱ grade) (35 cases treated with CPAP + PS and 51 cases treated with CPAP ) And severe HMD group (Ⅲ, Ⅳ grade) 64 cases (mechanical ventilation + PS treatment in 44 cases, mechanical ventilation in 20 cases), compared the different degree of HMD children with PS and not treated with PS treatment effect and complications. Results The overall cure rate was 75.3%. The cure rates of children with HMD using PS were higher than those of the control group (CPAP alone or mechanical ventilation). The number of HMD treated with CPAP + PS in mild and moderate HMD group was significantly changed to mechanical ventilation There was a statistically significant difference between the two groups (χ2 = 5.447, P <0.05). PS combined with mechanical ventilation in severe HMD group the incidence of complications in children with mechanical ventilation was lower (P <0.05). Conclusion The combination of PS treatment of children with HMD than the simple application of CPAP or mechanical ventilation have a significant effect, can improve the cure rate.