CAJ | 학술논문

目的：观察不同首次剂量猪肺磷脂注射液治疗新生儿肺透明膜病（ hyaline membrane disease ， HMD）的临床效果。方法选取86例HMD患儿并采用信封法随机分为两组各43例，对照组首剂量采用100 mg/kg，观察组首剂量采用200 mg/kg，根据患儿病情改善情况，可间隔12 h给药100 mg/kg，但总剂量不超过400 mg/kg/d。所有患儿在采用猪肺磷脂注射液治疗的基础上均配合对症支持治疗。观察两组患儿需接受第2剂、第3剂猪肺磷脂注射液治疗情况及两组患儿在治疗前及治疗12h后血气指标变化情况，同时观察两组患儿治疗前后胸片X线HMD分级情况及两组患者治疗转归、并发症发生情况和机械通气率。结果观察组患儿接受第2剂、第3剂猪肺磷脂注射液治疗比例均明显低于对照组（P＜0．05）；两组患儿治疗前血气指标无显著差异，但观察组治疗后PaO2明显高于对照组（P＜0．05），PaCO2明显低于对照组（P＜0．05）；两组患儿治疗前胸片X线HMD分级无显著差异，但治疗后观察组较对照组显著改善（P＜0．05）；观察组机械通气率、并发症发生率及死亡率均低于对照组，但差异不显著（P＞0．05）。结论对HMD患儿采用猪肺磷脂注射液治疗时，首次大剂量（200 mg/kg）效果优于首次小剂量（100 mg/kg）。
목적：관찰불동수차제량저폐린지주사액치료신생인폐투명막병（ hyaline membrane disease ， HMD）적림상효과。방법선취86례HMD환인병채용신봉법수궤분위량조각43례，대조조수제량채용100 mg/kg，관찰조수제량채용200 mg/kg，근거환인병정개선정황，가간격12 h급약100 mg/kg，단총제량불초과400 mg/kg/d。소유환인재채용저폐린지주사액치료적기출상균배합대증지지치료。관찰량조환인수접수제2제、제3제저폐린지주사액치료정황급량조환인재치료전급치료12h후혈기지표변화정황，동시관찰량조환인치료전후흉편X선HMD분급정황급량조환자치료전귀、병발증발생정황화궤계통기솔。결과관찰조환인접수제2제、제3제저폐린지주사액치료비례균명현저우대조조（P＜0．05）；량조환인치료전혈기지표무현저차이，단관찰조치료후PaO2명현고우대조조（P＜0．05），PaCO2명현저우대조조（P＜0．05）；량조환인치료전흉편X선HMD분급무현저차이，단치료후관찰조교대조조현저개선（P＜0．05）；관찰조궤계통기솔、병발증발생솔급사망솔균저우대조조，단차이불현저（P＞0．05）。결론대HMD환인채용저폐린지주사액치료시，수차대제량（200 mg/kg）효과우우수차소제량（100 mg/kg）。
Objective To understand the clinical effects of lung phospholipid injection of different initial dose in the treatment of Neonatal Hyaline Membrane Disease ( HMD) .Method 86 cases of children with HMD were randomly divided into two groups.43 cases in the control group used 100mg/kg as the first dose, while the other 43 cases in the experimental group used as the first dose 200mg/kg.Another dose of 100mg/kg at an interval of 12 hours was given according to the improvement of the health situation of the children , with the total dose not exceeding 400mg/kg/d.All children weretreated with Curosurf therapy based on symptomatic and supportive treatment .Observed two groups of children on the firsttwo, the first three Curosurf treatments.Observed in children before treatment and after 12h for blood gas changes.Beforeand after treatment observed in children with chest X-ray HMD for grading situation.Findings The experimental groupreceived the first two, the first three Curosurf ratio were significantly lower than the control group (P <0.05).Two groupsof children before treatment showed no significant difference in blood , but the experimental group after treatment , PaO2 wassignificantly higher (P <0.05), PaCO2 was significantly lower than the control group (P <0.05).Two groups of childrenbefore treatment, chest X-ray was no significant difference HMD grade , but after treatment, chest X-ray of the experimentalgroup than the control group HMD grade improved significantly , and the difference was statistically significant (P <0.05).2 cases of the experimental group (4.65%) underwent treatment in the use of mechanical ventilation PS treatment , thecontrol group of 8 patients (18.60%) with mechanical ventilation therapy, combination and intracranial hemorrhageobserved one case (2.33%), were combined and three cases of pneumothorax , Intracranial hemorrhage in 2 cases, theobservation group 1 cases (2.33%) deaths in the control group, 4 cases (9.30%) died in the observation groupmechanical ventilation rate, incidence of complications and mortality rates were lower than the control group , but thedifference was not significant (P >0.05).Conclusion the HMD were treated with Curosurf treatment, the first dose(200mg/kg) was better than the first dose (100mg/kg).