肺表面活性物质治疗足月新生儿肺出血的临床研究

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (4): 454-458.

肺表面活性物质治疗足月新生儿肺出血的临床研究

潘荣华¹, 张士发², 邰海服², 胡芳², 陈爱斌², 茅双根²

¹皖南医学院第一附属医院药剂科,
²儿科,芜湖 241001,安徽

收稿日期:2013-11-25 修回日期:2014-04-11 出版日期:2014-04-26 发布日期:2020-07-24
通讯作者: 张士发,通信作者,男,硕士,主任医师,副教授,硕士生导师,主要研究方向:新生儿疾病。Tel:13865537787 E-mail:wuhuzhangsf@163.com
作者简介:潘荣华,男,本科,主管药师,研究方向:临床药学。
基金资助:
芜湖市2009年度科技计划重点项目(卫生类-2-7)

Clinical application of pulmonary surfactants to full term infants with pulmonary hemorrhage

PAN Rong-hua¹, ZHANG Shi-fa², TAI Hai-fu², HU Fang², CHENG Ai-bin², MAO Shuang-gen²

¹Department of Hospital Pharmacy,
²Department of pediatrics, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China

Received:2013-11-25 Revised:2014-04-11 Online:2014-04-26 Published:2020-07-24

摘要/Abstract

摘要： 目的: 观察外源性肺表面活性物质(pulmonary surfactant,PS)在足月新生儿肺出血治疗中的安全性和疗效。方法: 40例肺出血足月新生儿,随机分为PS组(机械通气+气管内滴注血凝酶和PS)和对照组(机械通气+气管内滴注血凝酶),每组20例,两组患儿用药后6 、12 、24 h 分别桡动脉采集血样行血气分析,同时记录呼吸机的相关参数[呼吸力学指标:吸气峰压(PIP)和呼吸系统顺应性(Crs);患儿的病死率、肺出血停止平均时间和撤离呼吸机时间。结果: PS组治愈18例,死亡2例,对照组治愈17例,死亡3例,两组病死率(10% vs 15%)比较差异无统计学意义(P>0.05);PS组患儿肺出血停止时间和撤离呼吸机时间较对照组明显缩短,差异均有统计学意义(P均<0.05);PS组各时间点呼吸力学指标PIP 均低于对照组,而Crs均高于对照组,差异均有统计学意义(P均<0.05);PS组各时间点氧动力学指标动脉血氧分压(PaO₂)和氧合指数(PaO₂/FiO₂)均高于对照组,差异均有统计学意义(P均<0.05),两组动脉血二氧化碳分压(PaCO₂)在各时间点比较差异无统计学意义(P均>0.05)。结论: 外源性PS在足月新生儿肺出血的治疗中是安全、有效的。

关键词: 肺表面活性物质, 肺出血, 足月新生儿

Abstract: AIM: To evaluate the efficacy and safety of the exogenous pulmonary surfactants(PS) in the treatment of full term neonates with pulmonary hemorrhage. METHODS: Forty full-term newborns with pulmonary hemorrhage were equally randomized into PS group (mechanical ventilation+PS and instillation of hemocoagulase via endotracheal tube,n=20) and control group(mechanical ventilation+ hemocoagulase instillation via endotracheal tube,n=20).The blood was obtained in the two groups via radial artery respectively at 6, 12,24 h after intervention for blood gas analysis.Other data were maintained concerning the indexes of respiratory mechanics(PIP and Crs), oxygen kinetic(PaCO₂,PaO₂ and PaO₂/FiO₂), case fatality rate, mean time for stoppage of pulmonary hemorrhage and withdrawal of the breathing apparatus. RESULTS: In PS group, 18 cases were cured and 2 cases died, and in the controls, 17 cases were cured and death occurred in 3 cases. The case fatality rate was 10% vs 15% for the two groups, there was no statistically significant difference (P>0.05).The time for hemorrhage stoppage and withdrawal of the ventilator was significantly reduced in PS group, and the indexes of PIP at each time point were lower, whereas the levels of Crs, PaO₂ and PaO₂/FiO₂ were elevated; compared with the controls,there were statistically significant difference (all P<0.05), while there was no statistically significant difference about the PaO₂ at each point (all P<0.05) had no difference. CONCLUSION: The exogenous PS is safe and effective in treatment of full-term neonates with pulmonary hemorrhage.

Key words: pulmonary surfactant, pulmonary hemorrhage, full-term newborn

中图分类号:

R722.15

潘荣华, 张士发, 邰海服, 胡芳, 陈爱斌, 茅双根. 肺表面活性物质治疗足月新生儿肺出血的临床研究[J]. 中国临床药理学与治疗学, 2014, 19(4): 454-458.

PAN Rong-hua, ZHANG Shi-fa, TAI Hai-fu, HU Fang, CHENG Ai-bin, MAO Shuang-gen. Clinical application of pulmonary surfactants to full term infants with pulmonary hemorrhage[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(4): 454-458.

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