Ferrara T B, Hoekstra R E, Couser R J, Gaziano E P, Calvin S E, Payne N R, Fangman J J
Division of Neonatology, Abbott-Northwestern Hospital, Minneapolis, Minnesota.
J Pediatr. 1994 Jan;124(1):119-24. doi: 10.1016/s0022-3476(94)70266-7.
Little information is available regarding the effect of surfactant on outcome for infants born at or before 26 weeks of gestation. We addressed this issue by reviewing records of 310 infants born at gestational ages of 23 through 26 weeks who were admitted to our nursery from 1986, when surfactant was introduced, through 1990. Surfactant was administered to 154 infants (5 during a single-dose prevention study, 25 during a multiple-dose prevention study, 124 while receiving a Food and Drug Administration treatment investigational new drug); 156 infants were not treated with surfactant. Seventy-three percent of the treated infants survived, compared with 55% of the nontreated infants. Increased survival occurred at all gestational ages between 23 and 26 weeks but were greatest in infants born at 23 and 24 weeks. At follow-up, no differences in neurologic outcome were detected between surfactant-treated and nontreated infants. We conclude that surfactant use in extremely premature infants improves survival rates without increasing the proportion of impaired survivors.
关于表面活性剂对妊娠26周及以前出生婴儿预后的影响，目前所知信息甚少。我们通过回顾1986年（引入表面活性剂之年）至1990年期间入住我院新生儿病房的310例孕龄在23至26周的婴儿记录来解决这一问题。154例婴儿接受了表面活性剂治疗（5例在单剂量预防研究中、25例在多剂量预防研究中、124例在接受美国食品药品监督管理局治疗性研究新药期间）；156例婴儿未接受表面活性剂治疗。接受治疗的婴儿中有73%存活，而未接受治疗的婴儿存活率为55%。在23至26周的所有孕龄中，存活率均有所提高，但在23周和24周出生的婴儿中提高幅度最大。随访时，接受表面活性剂治疗和未接受治疗的婴儿在神经学预后方面未发现差异。我们得出结论，在极早产儿中使用表面活性剂可提高存活率，且不会增加存活但有功能障碍婴儿的比例。
