目的 探討重組人凝血因子Ⅶa聯(lián)合表面活性物質(zhì)豬肺磷脂注射液治療新生兒肺出血療效。方法 選擇2013年6月-2017年6月在安陽市第六人民醫(yī)院出生或診治的肺出血新生兒患者64例，隨機(jī)分為對(duì)照組和觀察組，各32例，兩組患兒在給予基礎(chǔ)治療的同時(shí)，對(duì)照組給予血凝酶氣管內(nèi)注射+豬肺磷脂注射液治療；觀察組給予靜脈注射重組人凝血因子Ⅶa+豬肺磷脂注射液治療。比較兩組患兒的臨床療效，觀察兩組患兒肺出血時(shí)間，治療前、治療后6、24、48 h血?dú)夥治鲋笜?biāo)、凝血功能。結(jié)果 觀察組肺出血時(shí)間明顯少于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組治療后24 h止血率為93.75%，顯著高于對(duì)照組的56.25%（P<0.05）。觀察組和對(duì)照組的總止血率分別為100%、90.6%，兩組相比差異無統(tǒng)計(jì)學(xué)意義。兩組患兒在治療后，血?dú)庵笜?biāo)明顯改善，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且在治療后各時(shí)間點(diǎn)觀察組的效果顯著優(yōu)于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。與治療前相比，兩組患兒治療后的凝血酶原時(shí)間（PT）、活化部分凝血活酶時(shí)間（APTT）、D-二聚體（DD）顯著降低，纖維蛋白原（Fbg）含量明顯上升，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組的PT、APTT、DD明顯低于對(duì)照組，且觀察組Fbg含量顯著高于對(duì)照組（P<0.05）。對(duì)照組治愈率為84.38%，觀察組治愈率為93.75%，兩組相比差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 重組人凝血因子Ⅶa聯(lián)合表面活性物質(zhì)治療的效果更顯著，可有效控制新生兒肺出血病情發(fā)展，緩解患兒呼吸窘迫，提高患兒生存質(zhì)量。

Objective To investigate the curative efficacy of recombinant human coagulation factor Ⅶa and hemagglutination enzyme l combined with surfactant for neonatal pulmonary hemorrhage. Methods From June 2013 to June 2017, 64 neonates with pulmonary hemorrhage were diagnosed and treated in our hospital. 64 neonates with pulmonary hemorrhage were randomly divided into two groups of control group (n=32) and observation group (n=32). Two groups were given basic treatment;at the same time control group received hemagglutination enzyme l + PS treatment; and the observation group was given recombinant human coagulation factor Ⅶa +PS treatment. The clinical curative effect of two groups were compared. Results The observation group pulmonary hemorrhage time was significantly less than the control group (P<0.05), and after treatment 24 h the observation group of hemostatic rate was 93.75% higher than that of the control group (56.25%, P<0.05). The total bleeding rates in the observation group and the control group were 100%, 90.6% respectively, and the difference between two groups was no significant. After treatment, the blood gas indexes of the two groups were significantly improved (P<0.05) and the effect of the observation group was better than control group at each time point (P<0.05). Compared with before treatment, the two groups of PT, APTT significantly decreased after treatment, the content of DD increased significantly (P<0.05). The observation group of PT, APTT was significantly lower than the control group, and the content of DD in observation group was significantly higher than the control group (P<0.05). 27 (84.38%) cases was cured in control group, and 30 (93.75%) cases in observation group, the difference between the two groups was not statistically significant. Conclusion Recombinant human coagulation factor Ⅶa combined with surfactant for neonatal pulmonary hemorrhage have more significant effect, which can effectively control the disease development of neonatal pulmonary hemorrhage, relieving respiratory distress, improving the quality of life of children