目的评价早期不同剂量肺表面活性物质(curosurf)对48例早产儿肺透明膜病(NRDS)的治疗作用。方法25例患肺透明膜病的早产儿经气管内注入curosurf(200mg.kg-1.次-1)为治疗组;另外23例注入curosurf(100mg.kg-1.次-1)作为对照组。两组均予经鼻塞持续气道正压通气(NCPAP)呼吸支持,比较两组患儿的临床症状体征、吸入氧浓度变化、血气变化、氧疗时间、并发症、住院时间、呼吸支持时间及住院费用。结果治疗后两组患儿症状体征明显好转,吸入氧浓度和血气分析情况较治疗前显著改善。两组比较,治疗4小时以后治疗组吸入氧浓度、血气分析改善情况明显优于对照组;治疗组肺部感染和慢性肺疾病发生率低于对照组;住院时间、呼吸支持时间、总氧疗时间均明显低于对照组;而两组总住院费用无明显差异。结论早期应用足量肺表面活性物质能有效治疗早产儿肺透明膜病,与小剂量比较,住院时间和氧疗时间短,肺部感染、慢性肺疾病发生率低,而不增加总住院费用。 Objective To evaluate the therapeutic effect of early different doses of pulmonary surfactant (curosurf) on 48 cases of premature infants with hyaline membrane disease (NRDS). Methods Twenty-five preterm infants with hyaline membrane disease were treated with curosurf (200 mg.kg-1. Sub-1) by endotracheal intratracheal injection. Another 23 infusions of curosurf (100 mg.kg-1. Sub-1) . The two groups were given nasal continuous positive airway pressure (NCPAP) respiratory support, clinical symptoms and signs, changes in inhaled oxygen concentration, blood gas changes, oxygen therapy time, complications, hospital stay, respiratory support time Hospital costs. Results After treatment, the symptoms and signs of children in the two groups improved obviously. The inhaled oxygen concentration and blood gas analysis were significantly improved compared with those before treatment. Compared with the control group, the incidence of pulmonary infection and chronic lung disease in the treatment group was lower than that in the control group; the duration of hospitalization, respiratory support, total oxygen therapy Time were significantly lower than the control group; while there was no significant difference between the two groups in total hospital costs. Conclusions The early application of sufficient pulmonary surfactant can effectively treat hyaline membrane disease in preterm infants. Compared with the low dose, hospitalization time and oxygen therapy time are short, and the incidence of pulmonary infection and chronic lung disease is low without increasing the total cost of hospitalization.