CAJ | 학술논문

目的：探讨不同剂量肺表面活性物质（Pulmonary surfactant ，PS ）在气泡式鼻塞持续正压通气（Bubble nasal continuous positive airways pressure ，BNCPAP）治疗新生儿呼吸窘迫综合征（Neonatal respiratory distress syndrome ， NRDS）中的疗效。方法：将80例NRDS新生儿按数字随机法分为A组、B组、C组和对照组，每组20例。对照组采用气泡式鼻塞持续正压通气常规治疗，A组、B组和C组在对照组的基础治疗上经气管插管分别应用PS 40mg/kg、70mg/kg和100mg/kg。比较四组患儿治疗前、后的血气分析结果差异和不良反应、并发症的发生情况。结果：四组患儿治疗的有效率、治疗后血气分析和不良反应、并发症发生情况比较差异有统计学意义（P＜0．05）。A、B、C三组患儿治疗有效率、血气分析改善和不良反应、并发症发生率均高于对照组；A、B、C三组患儿治疗后血气分析结果也存在差异（P＜0．05）。C组患儿治疗有效率较A组提高，B组和C组患儿血气分析均较A组改善，但B组和C组患儿的不良反应和并发症发生率均高于 A 组；随着治疗用药浓度的增加，PS的治疗效果增加，差异有统计学意义（ P＜0.05）。结论：PS联合BNCPAP治疗NRDS效果良好，随着PS使用剂量的增加，患儿的疗效和血气分析改善效果更佳，且药效均持续72h仍有效，值得临床推广使用。
목적：탐토불동제량폐표면활성물질（Pulmonary surfactant ，PS ）재기포식비새지속정압통기（Bubble nasal continuous positive airways pressure ，BNCPAP）치료신생인호흡군박종합정（Neonatal respiratory distress syndrome ， NRDS）중적료효。방법：장80례NRDS신생인안수자수궤법분위A조、B조、C조화대조조，매조20례。대조조채용기포식비새지속정압통기상규치료，A조、B조화C조재대조조적기출치료상경기관삽관분별응용PS 40mg/kg、70mg/kg화100mg/kg。비교사조환인치료전、후적혈기분석결과차이화불량반응、병발증적발생정황。결과：사조환인치료적유효솔、치료후혈기분석화불량반응、병발증발생정황비교차이유통계학의의（P＜0．05）。A、B、C삼조환인치료유효솔、혈기분석개선화불량반응、병발증발생솔균고우대조조；A、B、C삼조환인치료후혈기분석결과야존재차이（P＜0．05）。C조환인치료유효솔교A조제고，B조화C조환인혈기분석균교A조개선，단B조화C조환인적불량반응화병발증발생솔균고우 A 조；수착치료용약농도적증가，PS적치료효과증가，차이유통계학의의（ P＜0.05）。결론：PS연합BNCPAP치료NRDS효과량호，수착PS사용제량적증가，환인적료효화혈기분석개선효과경가，차약효균지속72h잉유효，치득림상추엄사용。
Objective :To investigate the effect of different dose of pulmonary surfactant (PS) and bubble nasal contin-uous positive airways pressure (BNCPAP) in the treatment of Neonatal Respiratory Distress Syndrome (NRDS) . Methods :80 cases of NRDS were enrolled ,randomized to group A ,B ,C and control group ,20 cases in each group .The control group was treated with regular treatment .Besides of the treatment of control group ,group A ,B ,C were treated with PS in 40mg/kg ,70mg/kg and 100mg/kg respectively .The curative effect ,blood gas analysis ,adverse reaction and complication occurrence of the 4 groups were compared .Results:There were differences in the curative effect ,blood gas analysis ,adverse reaction and complication occurrence in the 4 groups(P<0 .05) .The curative effect and blood gas a-nalysis results of group A ,B ,C were better than that of control group while the occurrence of adverse reaction and com-plications were higher than that of control group (P<0 .05) .The occurrences of adverse reaction and complication of group B and C were higher than that of group A while the blood gas analysis was better than that of group A (P<0.05) .The curative effect of group C was higher than that of group A (P<0 .05) .The curative effect increased with the increase of PS dose(P<0 .05) .Conclusion:The treatment of PS and BNCPAP in NRDS was effective and the phar-macodynamic action lasted to the 72th hours .The curative effect was connected with PS dose .The effect of treatment of PS and BNCPAP in NRDS was better when the dose of PS increased gradually .