LISA技术治疗早产儿呼吸窘迫综合征临床观察  

Less Invasive Surfactant Administration Technology in Treating Preterm Infants with Respiratory Distress Syndrome

作　　者：刘艳红[1] 赵先锋 梁桂娟[1] 李远征[1] 闫安平[1] Liu Yanhong;Zhao Xianfeng;Liang Guijuan;Li Yuanzheng;Yan Anping(Zhengzhou People＇s Hospital, Henan Zhengzhou 450000, Chin)

机构地区：[1]郑州人民医院,河南郑州450000

出　　处：《儿科药学杂志》2018年第5期21-24,共4页Journal of Pediatric Pharmacy

摘　　要：目的:观察采用LISA技术治疗早产儿呼吸窘迫综合征(RDS)的临床疗效。方法:回顾性分析2014年5月至2016年4月我院收治并确诊为呼吸窘迫综合征、胎龄在28~32周的RDS早产儿共87例,根据治疗方法不同分为传统组和微创组。传统组采用INSURE技术,即先行气管插管后再将肺表面活性物质(PS)注入,注入完毕后拔出气管插管,改为持续正压通气(CPAP)辅助呼吸;微创组为出生后即给予双水平正压通气(Duo PAP)辅助呼吸,将胃管置入气管内,PS通过注射器针头缓慢经胃管注入,同时应用Duo PAP辅助呼吸,注入完毕后拔出胃管,继续Duo PAP辅助呼吸。比较两组患儿二次PS应用、药物反流比例,气漏、支气管肺发育不良(BPD)发生率及胸部X线片改变、机械通气比例情况。结果:微创组发生药物反流的比例低于传统组,差异有统计学意义(P<0.05)。微创组需要二次应用PS的比例明显低于传统组,差异有统计学差异(P<0.05);传统组5例需机械通气,微创组0例,两组比较差异有统计学意义(P<0.05);两组患儿BPD、气漏发生率及胸部X线片改变比较差异无统计学意义(P>0.05)。结论:采用LISA技术治疗早产儿RDS可有效缓解患儿呼吸窘迫,保证PS用药剂量的准确性,减少住院费用,降低机械通气率,避免气管插管导致的肺损伤。Objective： To observe the efficacy of less invasive surfactant administration（ LISA） technology in treating preterm infants with respiratory distress syndrome（ RDS）. Methods： Eighty-seven RDS children born at 28 to 32 weeks were analyzed retrospectively from May 2014 to April 2016 in our hospital. The traditional group was treated with INSURE technology,injected pulmonary surfactant（ PS） after the trachea cannula,took out the trachea cannua,made the continuous positive-pressure ventilation for assisted respiration.The minimally invasive group was treated with LISA technology,the bilevel positive airway pressure（ Duo PAP） for assisted respiration was applied after birth,put the stomach tube into the trachea,injected PS into the stomach tube through the syringe needle with the Duo PAP for assisted respiration,took out the stomach tube after the injection,compared the secondary application of the PS between the two groups infants,the drug reflux rate,rate of air leak,the BPD incidence rate,the X-ray change in chest,mechanical ventilation rate. Results： The rate of the drug reflux in the minimally invasive group was lower than that of the traditional group,and the difference was statistically significant（ P〈0. 05）. The rate of the secondary application of the PS was obviously lower than that of the traditional group,and the difference was statistically significant（ P 〈 0. 05）. Five cases in the traditional group needed mechanical ventilation,while 0 case in the minimally invasive group,and the difference between the two groups was statistically significant（ P 〈 0. 05）. The differences of the BPD incidence rate,rate of air leak,the X-ray change between the two group had no statistic significance.Conclusion： Using LISA technology in treating RDS is feasible. Moreover,early invasive mechanical ventilation exposure is significantly reduced by this method,which can ensure the accuracy of PS’s dosage,reduce the hospitalized expense and mechanical ventilation rate,avoid the lung i

关 键 词：LISA技术 呼吸窘迫综合征 早产儿 

分 类 号：R722.1[医药卫生—儿科]