摘要
目的:探讨大剂量牛肺泡表面活性物质(PS)治疗新生儿呼吸窘迫征(NRDS)的临床医学价值和经济价值。方法:前瞻性选取本院新生儿科2017年2月至2019年8月期间诊治的90例NRDS患儿,采用简单随机分组方法分为常规组和研究组,每组各45例。所有NRDS患儿均给予持续气道正压通气(CPAP)治疗、化痰和抗感染等基础治疗,常规组和研究组分别取70mg/kg标准剂量和100mg/kg大剂量PS注入气管插管内。观察两组NRDS患儿治疗前和治疗48h血气分析指标[动脉血氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、pH值]和呼吸机参数[呼气末正压(PEEP)、吸入氧浓度(FiO2)、呼吸指数(RI)]变化,并记录两组NRDS患儿CPAP时间、PS用药次数、并发症发生率、病死率、住院时间及医疗总费用等情况。结果:两组NRDS患儿治疗48h后PaO2、pH、PEEP均明显升高,PaCO2、FiO2、RI均明显下降均明显下降(P<0.05);与常规组治疗48h比较,研究组PaO2、pH、PEEP显著较高,PaCO2、FiO2、RI显著较低(P<0.05)。研究组NRDS患儿并发症发生率8.89%、病死率2.22%略低于常规组13.33%、4.44%,差异无统计学意义(P>0.05),研究组CPAP时间、PS用药次数均少于常规组(P<0.05)。研究组住院时间、医疗总费用均少于常规组(P<0.05),与标准剂量70mg/kg PS治疗NRDS比较,大剂量100mg/kg PS可节省医疗费用约7200元/例,研究组45例NRDS患儿共节省约32.40万人民币。结论:与标准剂量70mg/kg PS治疗NRDS比较,补充大剂量100mg/kg PS的疗效更佳,临床医学价值和经济价值均显著。
Objective:To investigate the clinical and economic values of high dose bovine alveolar surfactant(PS)in the treatment of neonatal respiratory distress syndrome(NRDS).Methods:90 cases of NRDS diagnosed and treated in the Department of Pediatrics of our hospital from February 2017 to August 2019 were prospectively selected and divided into the routine group and the study group with the simple random number table method,45 cases in each group.All NRDS patients were treated with CPAP,expectoration and anti infection.70 mg/kg standard dose and 100 mg/kg high dose PS were injected into tracheal intubation in routine group and study group respectively.The changes of blood gas analysis indexes(PaO2,PaO2,pH)and ventilator parameters(PEEP,FiO2,RI)were observed before and 48 hours after treatment,and the CPAP time,PS medication times,complication rate,mortality,length of hospital stay and total medical expenses were recorded.Results:Values of PaO2,pH and PEEP were significantly increased and PaCO2,FiO2 and RI were significantly decreased in the two groups 48 hours after treatment,and the difference was statistically significant(P<0.05).Values of PaO2,pH,PEEP,PaCO2,FiO2 and RI of the study group were significantly higher than those of the control group.The difference was statistically significant(P<0.05).The complication rate and mortality rate of NRDS in the study group were 8.89%and 2.22%respectively,which were slightly lower than those in the control group(13.33%and 4.44%).There was no significant difference(P>0.05).The time of CPAP and the times of PS administration in the study group were lower than those in the control group(P<0.05).The length of stay and the total cost of medical treatment in the study group were less than those in the routine group,and the difference was statistically significant(P<0.05).Compared with the standard dose of 70 mg/kg PS in the treatment of NRDS,the high dose of 100 mg/kg PS can save about 7200 yuan/case of medical expenses,and the total savings of 45 NRDS patients in the study group are about 324000 yuan.Conclusion:Compared with the standard dose of 70 mg/kg PS in the treatment of NRDS,the effect of high dose of 100 mg/kg PS is better,with significant clinical and economic values.
作者
陈琨
秦华均
CHEN Kun;QIN Huajun(Chongqing Three Gorges Central Hospital, Chongqing 404000, China)
出处
《河北医学》
CAS
2020年第9期1573-1577,共5页
Hebei Medicine
基金
重庆市卫健委医学科研资助项目,(编号:2014MSXM137)。
关键词
新生儿呼吸窘迫征
牛肺泡表面活性物质
临床疗效
并发症
经济价值
Neonatal respiratory distress syndrome
Bovine alveolar surfactant
Clinical efficacy
Complications
Economic value
