CAJ | 학술논문

目的：探讨肺表面活性物质（ PS）联合布地奈德对急性呼吸窘迫综合征（ ARDS）极低出生体质量儿血气分析的影响，并评价用药的治疗效果。方法：2013年12月～2014年11月在大庆油田总医院新生儿科收治的的胎龄＜33周、出生体质量＜1500 g、出生6小时内发生ARDS的早产儿28例，随机分为实验组和治疗组，实验组使用肺表面活性物质（固尔苏）100mg／kg＋布地奈德0．25mg ／kg（男8例，女6例）气管内滴入配合机械通气，治疗组单独使用肺表面活性物质100mg／kg（男9例，女5例）气管内滴注配合机械通气，药物滴注时间在出生60分钟内。监测2组的血气情况。结果：实验组新生儿与治疗组第1、6、12、24小时血气分析pH值、氧分压（ Pa O2）、二氧化碳分压（ pa CO2）、肺泡动脉氧分压差（ AaDO2）比较均有显著差异（ P＜0．05）。结论：用PS联合布地奈德对极低出生体质量儿ARDS血气分析明显改善，改善呼吸困难，缩短吸氧时间，有利于早产儿尽早停氧，降低了肺损伤，减轻了患者的医疗费用，值得临床推广。
목적：탐토폐표면활성물질（ PS）연합포지내덕대급성호흡군박종합정（ ARDS）겁저출생체질량인혈기분석적영향，병평개용약적치료효과。방법：2013년12월～2014년11월재대경유전총의원신생인과수치적적태령＜33주、출생체질량＜1500 g、출생6소시내발생ARDS적조산인28례，수궤분위실험조화치료조，실험조사용폐표면활성물질（고이소）100mg／kg＋포지내덕0．25mg ／kg（남8례，녀6례）기관내적입배합궤계통기，치료조단독사용폐표면활성물질100mg／kg（남9례，녀5례）기관내적주배합궤계통기，약물적주시간재출생60분종내。감측2조적혈기정황。결과：실험조신생인여치료조제1、6、12、24소시혈기분석pH치、양분압（ Pa O2）、이양화탄분압（ pa CO2）、폐포동맥양분압차（ AaDO2）비교균유현저차이（ P＜0．05）。결론：용PS연합포지내덕대겁저출생체질량인ARDS혈기분석명현개선，개선호흡곤난，축단흡양시간，유리우조산인진조정양，강저료폐손상，감경료환자적의료비용，치득림상추엄。
Objective:To explore the influence of Blood gas analysis in very low birth weight premature with acute respiratory distress syndrome ( ARDS) after using pulmonary surfactant(PS) mixed with budesonide,and evaluate the therapeutic effect of combination. Methods:Twenty-eight premature infants with gestational age <33weeks,birth weight <1500 g,whose ARDS occurred within 6 hours after birth were andomly assigned into the experimental group and treatment group in Daqing Oil Field Gneral Hspital from December 2013 to November 2014,Experimental group using lung pulmonary surfactant 100mg/kg +budesonide 0.25mg/kg (male 8 cases, female 6 ca-ses) drip endotracheal cooperate with mechanical ventilation.The treatment group used alone lung pulmonary surfactant ( male 9 case,fe-male 5 cases) , 100mg/kg endotracheal drip with mechanical ventilation, drug drip time within 60 minutes after birth.Track two groups of Blood gas analysis.Results:The experimental group a newborn and the treatment group 1, 6, 12, 24 h blood gas analysis of pH value, oxygen partial pressure(Pa O2), CO2 partial pressure (Pa CO2), alveolar artery oxygen partial pressure difference (AaDO2) were sig-nificant differences (P <0.05).Conclusion:using PS joint budesonide on ARDS could improve blood gas analysis, improve the diffi-culty in breathing, shorten the time of oxygen, might be advantageous to the premature stop oxygen as soon as possible, reduce the lung injury, relieve the patient's medical expenses, worth clinical promotion.