RÉSUMÉ
Objective To observe the effect of pulmonary surfactant(PS) on lung function and ventilator parameters of neonatal respiratory distress syndrome(NRDS) in the advanced stage.Methods Twenty-eight infants with NRDS were given PS in one dose by endotracheal intubation on the left side,right side,feet high with head low,and level decub respectively.The dose of PS was 100-150 mg/kg each time,each posture slow note of the drug were required 1/4,out of the straw,hand-controlled ventilation,to reduce fluid loss,with the exception of a clear airway obstruction,within 6 hours after the administration not to shoot back suction,to give mechanical ventilation after the injection.Lung function parameters were also measured:pressure of oxygen in artery[p_a(O_2)],carbon dioxide partial pressure[p_a(CO_2)],the ratio of pressure of oxygen in artery and alveolar oxygen partial pressure[a/Ap(O_2)] and oxygenation index(OI) were determined.Ventilator parameters were determined:oxygen concentration(FiO_2),oxygen peak(PIP),end-expiratory positive pressure(PEEP) and mean airway pressure(MAP) were determined.These numerical data were analyzed and compared before and after treatment with PS.Clinical manifestations,thoracic X-ray changes,survival rate and incidence rate of complications were also analyzed and compared before and after PS therapy.Results p_a(O_2),a/Ap(O_2) showed significant upgrade and OI had a decrease after PS administration in comparison with those before PS therapy.The ventilator parameters(except for PEEP) acquired were also lower after drug administration than those in before drug therapy.There were significant differences in both stages(P_a90%,respiratory sound in 24 cases enhanced,the observation of chest film after 24 h indicated that,lesions in 21 cases improved significantly,5 cases took a favorable turn.The survival rate was 85.7%.The incidence rate of complication was as follows:pneumonia was 25%,patent ductus arteriosus was 10.7%,pneumorrhagia was 7.1% and intraventricular hemorrhage was 3.6%,respectively.Conclusion Respiratory function of NRDS is significantly improved by using PS in the advanced stage,and therapeutic effect is apparent.