The Effects Of Early Use Of Pulmonary Surfactant To Bronchopulmonary Dysplasia Of Lung Function In Infants

Objective:To assess the effect of early use of pulmonary surfactant on lung function inbronchopulmonary dysplasia infants, to provide a theoretical basis for early preventionof BPD in preterm.Methods:1. Retrospective analysis the clinical data in preterm infants in guangdong womenand children hospital who were born from April2011to April2012.2.The preterm infants diagnosed with BPD were divided into PS and non－PSgroups according to whether use PS after birth,Phone records and methods of outpatientfollow these two groups of children1year old,2years old height, weight and number ofadmissions due to respiratory diseases.3.Using the tidal breathing method, in chloral hydrate sedation, application U.S.Carefusiong spirometer, were detected in children1year old,2years old tidal breathinglung function, the data recorded in the BPD follow-up survey forms.4.The resulting data will be recorded in the follow-up data using Excel sheet toestablish a database, using SPSS19.0software for statistical analysis of the resulting data.Results:1.The general situation in preterm995cases of premature infants,eliminate48cases to give up or death within28days,947cases were included in the object of study,564cases were male (59.6%), female 383cases (40.4%),Average gestational age was32.25±1.35w. Average weight was2060±560g. Cases of BPD were54, the incidence of BPD patients in the study periodchildren was5.70%。2.The general situation in BPDIn this study, there are54cases of BPD, including4cases died, the6cases thefamily gave up treatment,4cases associated with other serious diseases, and theremaining40cases, included in the follow-up study，assessment on the basis of correctgestational age at36weeks,15mild cases (37.5%),16moderate cases (40.0%),9severecases (22.5%). The average gestational age was28.56±1.69weeks and the average birthweight was1152.82±216.41g; PS group was26cases, non-PS group was14cases.3. The two groups of BPD births and hospitalization situationPS group:The average gestational age was28.33±1.17w, the average weight was1070±110g, mild BPD9cases, moderate BPD11cases, severe BPD6cases; suffering21cases of pneumonia in hospital, suffering from pulmonary hemorrhage one case, one casehas a family history of asthma, RDS21patients; mean duration of mechanical ventilation13.32±5.49d, the average oxygen time59.04±4.32d; non-PS group, the averagegestational age of28.83±0.90weeks, the average weight of1140±900g, BPD6patientswith mild, moderate BPD5cases, severe BPD3cases,21cases of pneumonia in patientssuffering from pulmonary hemorrhage one case, one case had a family history of asthma,RDS11patients; mean duration of mechanical ventilation15.60±3.75d, the averageoxygen time62.38±4.01d;No significant differences in the severity of the two groups of children,χ2=0.307，p＞0.05；No significant difference of the two groups with gestational age, birth weight, incomplications during hospitalization, p>0.05; there is a significant difference in the twogroups of mechanical ventilation, in time of oxygen, p <0.05;4.follow-up results:1year old: PS group lost two cases, non-PS group lost one case; 2years of age: PS group lost one case, a non-PS group lost one case;1year old lung function parameters PS group is RR29.87±1.03beats/min, TPTEF/TE26.73±0.94%, VPEF/VE28.23±0.75%, Ti0.87±0.04s, Te1.28±0.04s, VT7.96±0.53ml/kg, height69.88±2.12cm, weight7.88±0.54kg; non-PS group RR30.77±1.01beats/min, TPTEF/TE25.75±0.77%, VPEF/VE27.27±0.78%, Ti0.87±0.04s,Te1.31±0.03s, VT7.53±0.51ml/kg, height70.00±2.08cm, weight7.760.87kg,statistical analysis showed that: non-PS group compared with PS group RR and Teincrease, TPTEF/TE, VPEF/VE2and VT decrease, P <0.05, significant difference, Tiwas no significant difference, P>0.05; comparing the two groups of children with height,weight, family history of asthma, a disease, the difference was not statistically significant,P>0.05; non-PS group admissions for respiratory diseases increased, the difference wasstatistically significant, P <0.05.Lung function parameters were2years old PS group is RR24.91±0.73beats/min,TPTEF/TE27.94±0.58%, VPEF/VE29.79±0.64%, Ti1.05±0.04s, Te1.46±0.05s,VT8.76±0.53ml/kg, height87.71±1.75cm, weight12.53±0.96kg; non-PS group RR25.75±0.75beats/min, TPTEF/TE27.41±0.61%, VPEF/VE28.89±0.72%, Ti1.06±0.04s, Te1.49±0.03s, VT8.30±0.48ml/kg, height86.33±3.56cm, weight12.00±0.63kg, non-PS group compared with PS group RR and Te increase, TPTEF/TE, VPEF/VE and VT decrease, P <0.05, significant difference, Ti was no significant difference, P>0.05; comparing the two groups of children with height, weight, family history of asthma,a disease, the difference was not statistically significant, P>0.05; non-PS groupadmissions for respiratory diseases increased, the difference was statistically significant, P<0.05.Conclusion:1.Early use of PS may improve BPD infants of one and two years old lung functionand reduce the number of admissions due to respiratory diseases.2.Early use of PS replacement therapy had no significant effect on BPD children1year old,2-year-old height,and weight.