目的 探討兩種肺泡表面活性物質(zhì)（PS）替代治療對早產(chǎn)兒呼吸、神經(jīng)系統(tǒng)的影響。方法 2013年2月—2016年12月選擇在中山市博愛醫(yī)院診治的早產(chǎn)兒呼吸窘迫綜合征97例作為研究對象，根據(jù)隨機(jī)數(shù)字表法分為觀察組48例與對照組49例，對照組給予豬肺磷脂注射液（固爾蘇）治療，觀察組治療給予注射用牛肺表面活性劑（珂立蘇），在給藥途徑中，不中斷進(jìn)行機(jī)械通氣，此后根據(jù)患兒臨床表現(xiàn)與呼吸困難改善情況可重復(fù)使用，最大使用次數(shù)不超過3次；兩組都治療觀察14 d。記錄并比較兩組的機(jī)械通氣時(shí)間、住院天數(shù)與住院費(fèi)用，兩組治療前后的肺泡內(nèi)正壓參數(shù)變化情況，行為神經(jīng)測定（NBNA）評分及神經(jīng)損傷因子情況。結(jié)果 觀察組的通氣時(shí)間、氧療時(shí)間與住院時(shí)間都明顯少于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后觀察組與對照組的肺泡內(nèi)正壓參數(shù)都明顯低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；同時(shí)治療后觀察組的肺泡內(nèi)正壓參數(shù)明顯低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后觀察組與對照組的糾正胎齡37周時(shí)NBNA評分分別為（36.98±3.11）分和（31.49±3.87）分，都明顯高于治療前的（25.72±2.92）分和（25.14±3.11）分，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后觀察組的NBNA評分明顯高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后觀察組與對照組的血清NSE含量明顯低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后觀察組的血清NSE含量也明顯低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 不中斷機(jī)械通氣給予注射用牛肺表面活性劑能改善呼吸窘迫綜合征患兒的肺功能，促進(jìn)患兒康復(fù)，且有利于患兒神經(jīng)功能的恢復(fù)，有很好的應(yīng)用價(jià)值。

Objective To investigate the effects of two kinds of pulmonary surfactant (PS) pathway replacement therapy on the breathe and nervous system in preterm infants. Methods From February 2013 to December 2016, 97 cases of preterm infants acute lung injury in our hospital diagnosis and treatment were selected and were randomly divided into observation group of 48 cases and 49 cases in the control group, the control group was given curosurf treatment, the observation group was given kelisu treatment, all the PS were rewarming to 37℃, the first dose were 200 mg/kg, then were given additional dose accorded to the clinical manifestations of the patients with disease rehabilitation, the highest dose of 400 mg/kg; two groups were treated with 14 d. Results The ventilation time, oxygen treatment time and hospitalization time in the observation group were significantly less than those of the control group (P<0.05). After treatment, the positive alveolar pressure parameters of the observation group and the control group were significantly lower than that before treatment (P<0.05), while the observation group were significantly lower than that of the control group (P<0.05). After treatment, the NBNA scores (correct fetal age 37 weeks) in the observation group and the control group were (36.98 ±3.11) points and (31.49 ±3.87) points, were significantly higher than that before treatment of (25.72 ±2.92) points and (25.14 ±3.11) points (P<0.05), and the observation group was significantly higher than the control group (P<0.05). After treatment, the serum NSE contents of the observation group and the control group was significantly lower than that before treatment (P<0.05), and the serum NSE content in the observation group was also significantly lower than that in the control group (P<0.05). Conclusion Kelisu in the treatment of preterm infants acute lung injury without interruption of mechanical ventilation can improve the pulmonary function, promote the rehabilitation of children, and improve the neurological function of children with acute lung injury, it has good application values.