摘要
目的探讨珂立苏应用剂量对晚期新生儿呼吸窘迫综合征的影响。方法选取2014年7月-2015年12月青海省妇女儿童医院收治的新生儿呼吸窘迫综合征患儿95例,依据随机数表法分为大剂量组和小剂量组,比较用药前、用药后1、6、12及24 h两组患儿血氧分压(PaO_2)、动脉血二氧化碳分压(Pa CO2)、肺泡动脉氧分压差[P(A-a)O2]、吸入氧体积分数(FiO)2、氧合指数(OI)、X线评分及相关指标。结果大剂量组48例,治愈25例,好转21例,无效2例,总有效率为95.83%;小剂量组47例,治愈20例,好转19例,无效6例,死亡2例,总有效率为82.98%。用药前,两组患儿的PaO_2、PaCO_2、P(A-a)O_2、FiO_2、OI、X线评分差异无统计学意义(P>0.05)。大剂量组患儿在用药后1 h PaO_2迅速恢复,且在用药后6、12及24 h持续上升。小剂量组患儿PaO_2亦有所升高,但用药后1 h变化幅度并不明显,用药后24 h PaO_2水平仍低于大剂量组。给药后1 h内,两组患儿的PaCO_2均有所下降,但变化并不明显,至用药后6 h,患儿PaCO_2较用药前降低,且在用药后12和24 h内维持稳定状态。给药后1 h,大剂量组患儿P(A-a)O_2降至200 mm Hg左右,小剂量组患儿的平均P(A-aO_2为(274.18±44.16)mm Hg,组间差异有统计学意义(P<0.05)。用药后6h,两组患儿的P(A-a)O_2差值最大,至24 h后仍有较大差距。用药后1、6、12及24 h,两组患儿的FiO_2均降低,组间差异无统计学意义(P>0.05)。给予大剂量珂立苏后,患儿OI在较短时间内(用药后1 h)迅速下降,接近正常水平,而小剂量组患儿至用药后12 h逐渐恢复正常。用药后12 h大剂量组患儿X线评分降低,同时小剂量组患儿X线评分虽低于用药前,但与同时间点大剂量组患儿比较,仍有较大差异(P<0.05)。结论大剂量珂立苏治疗呼吸窘迫综合征成效显著,能够有效改善新生儿血气指标,具有安全可靠、临床操作性高的特点。
Objective To investigate the effects of Calsurf application dose for late neonatal respiratory distress syndrome. Methods Ninety-five cases of neonatal respiratory distress syndrome in our hospital between July 2014 and December 2015 were selected, and divided into large-dose group and small-dose group according to a random number table. Pa02, PaC02, P（Aa）02, FLOE, OI and X line scores before treatment, 1, 6, 12 and 24 h after treatment were compared between the two groups . Results Among the 48 cases in the high-dose group, 25 cases were cured, 21 cases were improved, 2 cases did not get curative effect, the total effective rate was 95.83%; while among the 47 cases of the low-dose group, 20 cases wefe cured, 19 cases were improved, 6 cases had no curative effect, 2 cases died, the total efficiency was 82.98 %. Before treatment, Pa02, PaC02, P（Aa）02, Fi02, OI or X ray score was not significantly different between the two groups （P 〉 0.05）. In the high-dose group Pa02 rapid recovered 1 h after treatment, and continued to rise 6 , 12 and 24 h after treatment; in the small-dose group Pa02 also increased, but the change was not obvious 1 h after treatment, Pa02 level was still significantly lower than that in the high-dose group 24 h after treatment. PaCO2 reduced in both groups within 1 h after administration, but the change was not obvious; 6 h after treatment PaC02 was significantly lower than that before treatment and maintained stable 12 and 24 h after administration. P（Aa）O： dropped to about 200 mmHg in the high-dose group 1 h after administration, and in the low-dose group, the average P（Aa）O~ was （274.18 ~ 44.16） mmHg, the difference was statistically significant （P 〈 0.05）. P （Aa）O： had the biggest difference between the two groups 6 h after drug intake, there was still big difference 24 h after treatment. After treatment for 1, 6, 12 and 24 h, Fi02 in the two groups was significantly lowered, the difference between the groups was not statistically significant （P 〉 0.05）. After administration of high doses of Calsurf, OI decreased rapidly 1 h after treatment to nearly normal level, while in the low dose group OI gradually returned to normal after 12 h. X-ray scores were significantly reduced in the high-dose group 12 h after administration, while X-ray scores in the small-dose group were significantly lower than those before treatment but there were still big differences from those in the high-dose group at the same time point（P 〈 0.05）. Conclusions Large-dose Calsurf has remarkable effect on respiratory distress syndrome. It can effectively improve neonatal blood indicators, and has the advantages of safety, reliability and high clinical operability.
作者
扎西吉
王正岭
马凤美
吕文华
Xi-ji Za Zheng-ling Wang Feng-mei Ma Wen-hua Lyu(Department of Pediatrics, Qinghai Women and Children Hospital, Xining, Qinghai 810000, China)
出处
《中国现代医学杂志》
CAS
北大核心
2017年第2期113-118,共6页
China Journal of Modern Medicine
关键词
珂立苏
剂量
呼吸窘迫综合征
并发症
X线评分
Calsurf
dose
respiratory distress syndrome
complication
X line score
