不同种类肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效比较

Comparisons of efficacy of different pulmonary surfactants for the treatment of neonatal respiratory distress syndrome

摘要:

目的：综合分析进口肺表面活性物质（pulmonary surfactant，PS）猪肺磷脂注射液（猪 PS）与国产牛肺表面活性剂（牛 PS）治疗新生儿呼吸窘迫综合征（NRDS）的临床疗效，以便科学选用。方法：回顾分析2006年1月至2011年6月随机选用猪PS和牛PS治疗的180例Ⅳ级NRDS患儿（每组90例）的临床资料，比较两组胸片及不同时段血气分析结果改善、并发症的发生、住院时间及住院费用等。结果：猪PS组有效率（97%）高于牛PS组（83%）（P＜0.01）；猪PS组治愈率（84%）亦高于牛PS组（66%）（P＜0.01）；猪PS组气胸发生率（3%）低于牛PS组（7%）（P＜0.05)；猪PS组住院时间（21±4 d）较牛PS组（23±4 d）短（P＜0.05)；两组平均住院总费用差异无统计学意义（P＞0.05）。结论：治疗Ⅳ级NRDS猪PS优于牛PS。

Abstract:

OBJECTIVE: To compare the clinical efficacy of imported pulmonary surfactant (PS) pig lung phospholipids injection (pig PS) and domestic cattle lung surface-active agent (cattle PS) for the treatment of neonatal respiratory distress syndrome (NRDS). METHODS: A total of 180 cases of grade IV NRDS receiving pig PS (n=90) or cattle PS treatment (n=90) were enrolled. The blood gas analysis and chest X-ray results and the incidence of complications after treatment, and hospitalization time and cost were compared between the two treatment groups. RESULTS: The efficiency rate in the pig PS group (97%) was higher than in the catle PS group (83%) (P<0.01). The cure rate in the pig PS group was also higher than in the cattle PS group (84% vs 66%; P<0.01). The incidence of pneumothorax in the pig PS group was lower than in the cattle PS group (3% vs 7%; P<0.05). The hospitalization time in the pig PS group was shorter than in the cattle PS group (21±4 days vs 23±4 days; P<0.05). There were no significant differences in the total hospitalization cost between the two groups. CONCLUSIONS: Pig PS seems to be superior to cattle PS in the treatment of grade IV NRDS.