Grebennikov V A, Everstova T N, Safonov I V
Anesteziol Reanimatol. 1998 Jul-Aug(4):36-9.
HL surfactant was used for vital indications in 12 newborns with respiratory distress syndrome born at 28-36 weeks weighing 1000-2500 g at birth and postgestation age of up to 48 h, without apparent congenital diseases and evident signs of intrauterine infection and with intraventricular hemorrhages no more severe than of the second degree. Control group consisted of 12 babies with similar condition treated similarly but without surfactant. Surfactant HL was administered endotracheally in a dose of 50 mg/kg twice at 12-h interval. Good effect was attained in 4 newborns, stable deterioration in 2, and no effect in 6 children. The majority of artificial ventilation values were virtually the same in both groups, but 2 days after surfactant, FiO2 was significantly lower in the controls than in experimental group (0.37 +/- 0.05 vs. 0.64 +/- 0.4, p < 0.01), and VEI was higher in the controls (0.33 +/- 0.05 vs. 0.18 +/- 0.03, p < 0.05). VR, MAP, FiO2, and oxygenation index decreased slower in the test group than in the controls. The mean duration of treatment with hypoxic gaseous mixtures and artificial ventilation of the lungs in the test vs. control group were 143 +/- 60 and 288 +/- 45 h vs. 45.5 +/- 8.3 and 200.8 +/- 28.5 h, respectively. The incidence of air leakage syndrome was 83% (10 cases) in the test group and 17% (2 cases) in the control group, chronic pulmonary diseases developed in 3 (25%) babies in the test and in 1 (8.3%) in the control group. Seven (67%) children in the test group developed obstructive changes in the lungs vs. 1 child in the control group. One child (test group) died from causes other than pulmonary. Hospital stay was longer in the test group than in control (14.8 +/- 1.7 vs. 8.3 +/- 1.3 days, p < 0.01).
HL表面活性剂用于12例患有呼吸窘迫综合征的新生儿,这些新生儿在28 - 36周出生,出生体重1000 - 2500克,孕龄达48小时,无明显先天性疾病和宫内感染迹象,脑室内出血不超过二级。对照组由12例情况相似但未使用表面活性剂且接受类似治疗的婴儿组成。HL表面活性剂经气管内给药,剂量为50毫克/千克,每隔12小时给药两次。4例新生儿效果良好,2例病情稳定恶化,6例无效果。两组的大多数人工通气指标实际上相同,但在使用表面活性剂2天后,对照组的FiO2显著低于试验组(0.37±0.05对0.64±0.4,p<0.01),对照组的VEI较高(0.33±0.05对0.18±0.03,p<0.05)。试验组的VR、MAP、FiO2和氧合指数下降速度比对照组慢。试验组与对照组使用低氧气体混合物和肺人工通气的平均治疗时间分别为143±60和288±45小时以及45.5±8.3和200.8±28.5小时。试验组的空气泄漏综合征发生率为83%(10例),对照组为17%(2例),试验组3例(25%)婴儿和对照组1例(8.3%)婴儿发生慢性肺部疾病。试验组7例(67%)儿童出现肺部阻塞性改变,对照组1例。试验组1名儿童死于非肺部原因。试验组的住院时间比对照组长(14.8±1.7对8.3±1.3天,p<0.01)。