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目的综合比较肺表面活性物质(PS)合成和天然制剂治疗新生儿呼吸窘迫综合征(RDS)的效果和安全性。方法对符合条件的6篇研究文献,应用Meta分析方法进行定性、定量综合分析。结果与合成制剂相比较,天然制剂治疗新生儿RDS后72h内氧浓度(FiO2)和平均气道压力(MAP)低,而动脉血氧分压与肺泡氧分压的比率(a/A)高;两种PS制剂在降低患儿围产期死亡率以及治疗后脓毒败血症、肺出血、脑室内出血和动脉导管未闭发生危险性方面差异均无显著性(P>0.05),但合成制剂治疗者气胸发生率高P<0.05)。结论天然PS治疗新生儿RDS的疗效好于合成制剂;除气胸发生率高外,合成制剂在安全性上与人工制剂相似。
Objective To compare the efficacy and safety of pulmonary surfactant (PS) synthesis and natural preparations in the treatment of neonatal respiratory distress syndrome (RDS). Methods According to the six research documents that meet the requirements, Meta analysis method was used for qualitative and quantitative analysis. Results Compared with the synthetic preparations, the natural preparations had lower FiO2 and mean airway pressure (MAP) within 72h after neonatal RDS, while the ratio of arterial partial pressure of oxygen to alveolar pressure (a / A) was high There was no significant difference between the two PS preparations in reducing perinatal mortality and the risk of postoperative sepsis, pulmonary hemorrhage, intraventricular hemorrhage and patent ductus arteriosus (P> 0.05) Pneumothorax incidence was high P <0.05). Conclusion The therapeutic effect of natural PS on neonatal RDS is better than that of synthetic drugs. The high synthesis rate of pneumoperitoneum is similar to that of artificial preparations.