目的 探讨重组人凝血因子Ⅶa联合表面活性物质猪肺磷脂注射液治疗新生儿肺出血疗效。方法 选择2013年6月-2017年6月在安阳市第六人民医院出生或诊治的肺出血新生儿患者64例，随机分为对照组和观察组，各32例，两组患儿在给予基础治疗的同时，对照组给予血凝酶气管内注射+猪肺磷脂注射液治疗；观察组给予静脉注射重组人凝血因子Ⅶa+猪肺磷脂注射液治疗。比较两组患儿的临床疗效，观察两组患儿肺出血时间，治疗前、治疗后6、24、48 h血气分析指标、凝血功能。结果 观察组肺出血时间明显少于对照组，差异有统计学意义（P<0.05）；且观察组治疗后24 h止血率为93.75%，显著高于对照组的56.25%（P<0.05）。观察组和对照组的总止血率分别为100%、90.6%，两组相比差异无统计学意义。两组患儿在治疗后，血气指标明显改善，同组治疗前后比较差异有统计学意义（P<0.05）；且在治疗后各时间点观察组的效果显著优于对照组，差异有统计学意义（P<0.05）。与治疗前相比，两组患儿治疗后的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、D-二聚体（DD）显著降低，纤维蛋白原（Fbg）含量明显上升，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组的PT、APTT、DD明显低于对照组，且观察组Fbg含量显著高于对照组（P<0.05）。对照组治愈率为84.38%，观察组治愈率为93.75%，两组相比差异无统计学意义。结论 重组人凝血因子Ⅶa联合表面活性物质治疗的效果更显著，可有效控制新生儿肺出血病情发展，缓解患儿呼吸窘迫，提高患儿生存质量。

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