Speer C P, Harms K, Müller U, Schröter W, Curstedt T, Robertson B
Universitäts-Kinderklinik Göttingen, Stockholm.
Monatsschr Kinderheilkd. 1988 Feb;136(2):65-70.
14 preterm infants with severe respiratory distress syndrome (birthweight 1170 +/- 369 g, mean +/- 1SD) have been treated with a single dose of natural porcine surfactant (Curosurf, 200 mg/kg); follow up and outcome data were compared with matched controls (1200 +/- 288 g, n = 20). Treated infants showed improved oxygenation and gas exchange within minutes after surfactant application. Duration of intermittent positive pressure ventilation was significantly reduced in treated patients when compared to controls (surfactant treated: 16 d (mean value), controls 27 d, p less than 0.05). Similarly, total exposition in greater than 40% oxygen was 5.5 h in treated infants versus 79 h in controls (p less than 0.001). Pneumothorax occurred in 7 of the 20 control infants (35%), but in none of the treated patients (p less than 0.05). However, haemodynamically significant patent ductus arteriosus (PDA) occurred more often in the surfactant group (50% versus 30%, not significant). The incidence of PDA requiring treatment was the same in both groups. Occurrence of intracranial haemorrhage, bronchopulmonary dysplasia and retinopathy of prematurity was identical in both groups. Mortality was 25% in controls and 7% in treated babies. This study confirms the efficacy of surfactant treatment in neonates with severe respiratory distress syndrome.
14例患有严重呼吸窘迫综合征的早产儿（出生体重1170±369克，平均±1标准差）接受了单剂量天然猪肺表面活性物质（固尔苏，200毫克/千克）治疗；将随访及转归数据与匹配的对照组（1200±288克，n = 20）进行比较。治疗的婴儿在应用表面活性物质后数分钟内氧合及气体交换得到改善。与对照组相比，治疗患者的间歇正压通气时间显著缩短（表面活性物质治疗组：16天（平均值），对照组27天，p<0.05）。同样，治疗婴儿吸氧浓度大于40%的总时长为5.5小时，而对照组为79小时（p<0.001）。20例对照婴儿中有7例发生气胸（35%），但治疗患者中无一例发生（p<0.05）。然而，血流动力学显著的动脉导管未闭（PDA）在表面活性物质治疗组中更常见（50%对30%，无显著性差异）。两组中需要治疗的PDA发生率相同。两组颅内出血、支气管肺发育不良和早产儿视网膜病变的发生率相同。对照组死亡率为25%，治疗婴儿死亡率为7%。本研究证实了表面活性物质治疗对患有严重呼吸窘迫综合征新生儿的疗效。
