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目的:观察牛肺泡表面活性物质(珂立苏)治疗新生儿呼吸窘迫综合征(RDS)的临床疗效。方法:研究对象为2011年3月~2012年12月期间明确诊断为新生儿RDS的182例早产儿,胎龄≤35周,除常规应用机械通气和综合治疗外,应用肺泡表面活性物质(PS)治疗,其中应用珂立苏治疗者94例(观察组),猪肺泡表面活性物质(固尔苏)88例(对照组),对比两组机械通气相关指标、疗效指标、治疗后合并症发生率和转归,进行统计学分析。结果:研究发现用药后两组患儿临床症状均有所改善,血气分析指标好转,观察组起效时间慢于对照组,差异具有统计学意义(P<0.05)。对照组应用固尔苏治疗后1 h平均气道压(MAP)和吸入氧浓度(FiO2)可下调,氧合指数(P/F)值有所改善,与观察组比较差异具有统计学意义(P<0.05),但氧分压(PaO2)、二氧化碳分压(PaCO2)比较差异无统计学意义(P>0.05)。上述指标在12 h、24 h、48 h均有所改善,但差异无统计学意义(P>0.05)。两组患者机械通气时间、用氧时间、住院时间比较差异无统计学意义(P>0.05),治疗费用比较观察组低于对照组,差异具有统计学意义(P<0.05)。两组各种并发症比较差异无统计学意义(P>0.05)。两组患儿好转率、死亡率差异无统计学意义(P>0.05)。结论:珂立苏与固尔苏治疗新生儿RDS时疗效相当,固尔苏起效较珂立苏快,但珂立苏能在一定程度上减少住院费用。
Objective: To observe the clinical efficacy of bovine alveolar surfactant (Ke Li Su) in the treatment of neonatal respiratory distress syndrome (RDS). METHODS: A total of 182 preterm infants diagnosed with neonatal RDS were enrolled from March 2011 to December 2012. The gestational age was ≤35 weeks. In addition to routine mechanical ventilation and general treatment, the alveolar surfactant (PS) ) Were treated with Ke Li Su the treatment of 94 cases (observation group), porcine alveolar surfactant (Guer Su) 88 cases (control group), compared the two groups of mechanical ventilation related indicators, efficacy indicators, post-treatment complications Rate and outcome, for statistical analysis. Results: The study found that the clinical symptoms of both groups were improved after treatment, blood gas analysis indicators improved, the observation group onset time is slower than the control group, the difference was statistically significant (P <0.05). Compared with the observation group, the mean airway pressure (MAP) and inspired oxygen concentration (FiO2) were decreased and the oxygenation index (P / F) was improved at 1 h after the treatment with Gulbutol in the control group P <0.05), but there was no significant difference between PaO2 and PaCO2 (P> 0.05). The above indexes improved at 12 h, 24 h and 48 h, but the difference was not statistically significant (P> 0.05). There was no significant difference between the two groups in mechanical ventilation time, oxygen time and hospital stay (P> 0.05). The treatment cost was lower in the observation group than in the control group, with statistical significance (P <0.05). There was no significant difference between the two groups in various complication (P> 0.05). There was no significant difference in rates of improvement and mortality between the two groups (P> 0.05). Conclusion: The results of Ke Li Su and Guer Su Su treatment of neonatal RDS are comparable, Guer Su Su onset faster than Ke Li Su, but Ke Li Su to a certain extent reduce the cost of hospitalization.