【摘要】  目的：探讨牛肺表面活性剂防治早产儿呼吸窘迫综合征（NRDS）的疗效。方法：胎龄≤34周，体重≤1 700 g的早产儿38例，分为实验组与对照组。实验组随机分为两组，生后2～12 h内气管内注入牛肺表面活性剂（珂立苏）为预防组，发生NRDS后给予牛肺表面活性剂为治疗组，每组10例。对照组18例，未应用牛肺表面活性剂。观察每组临床表现、呼吸机通气天数、氧疗时间及住院天数等。结果：预防组中有7例未出现NRDS，治疗组中6例NRDS使用牛肺表面活性剂后于24 h内症状明显缓解或完全消失。X线显示实验组肺部病理表现明显改善，呼吸机通气天数为（5.0±5.8）d，氧疗时间为（7.6±5.4）d，住院天数为(21.5±7.3)d，较对照组明显减少，差异有统计学意义（P＜0.05）。实验组使用珂立苏后机械通气频率由（61.80±7.35）次/min下降至（42.56±5.67）次/min，平均气道压力由（15.2±1.41）cm H2O下降至（9.15±1.52）cm H2O；吸气峰压由用药前（26.08±2.02）cm H2O下降至（17.40±2.11）cm H2O，与对照组比较差异有统计学意义（P＜0.05）。结论：牛肺表面活性剂可降低早产儿RDS的发病率，减少呼吸机通气时间，降低呼吸机参数、用氧时间及住院天数，改善早产儿的预后。

【关键词】  早产儿；呼吸窘迫综合征；肺表面活性物质

        The Study of the Prevention and Treatment of Respiratory Distress Syndrome in Prematures by Pulmonary SurfactantLUO Jiamei, JIANG Jianyu　The Three Gorges Hospital of Chongqing, Chongqing Wanzhou  404000, China 　［Abstract］Objective:To explore the preventive and therapeutic effects of pulmonary surfactant (PS)Kelisu on respiratory distress syndrome (RDS) in prematures. Methods:A total of 38 prematures were randomly  divided into the control group (18 cases) which weren’t  administrated with Kelisu and experimental group (20 cases). The gestational age of these prematures were less than 34 weeks and the birth weight were less than 1,700 grams. The experimental group was divided into the prevention group (10 cases) which were administrated with Kelisu through airtube between 2～12 hours after birth and the treatment group (10 cases) which were diagnosed as RDS. The clinical manifestation, duration of ventilation and the time of oxygen supply were observed. Results: Seven cases in prevention group weren’t diagnosed as RDS. The symptoms of 6 cases in the treatment group were released or disappeared after using of Kelisu in 24 hours. The duration of ventilation which was (5.0±5.8) days, the time of oxygen supply (7.6±5.4 days) and hospital stay (21.5±7.3 days) of the experimental group were shorter than those of the control group (P<0.05). The rate of mechanical ventilation was dropped from (61.80±7.35) times per minute to 42.56±5.67 times per minute, peak inspiratory pressure was dropped from（15.2±1.41