改良INSURE技术治疗早产儿呼吸窘迫综合征的效果观察  

Therapeutic Effect of Modified INSURE Technique in the Treatment of Respiratory Distress Syndrome in Premature Infants

作　　者：江云[1] 李健[1] 黎瑞春[1] JIANG Yun;LI Jian;LI Ruichun

机构地区：[1]江西省九江市妇幼保健院,江西九江332000

出　　处：《中国医学创新》2020年第1期129-132,共4页Medical Innovation of China

基　　金：江西省卫生计生委科技计划项目(20197172)。

摘　　要：目的:分析改良INSURE技术治疗早产儿呼吸窘迫综合征(RDS)的效果。方法:选取2018年6月-2019年6月本院收治的68例RDS早产儿为研究对象,运用随机数字表法分为INSURE组(n=34)和LISA组(n=34),INSURE组采用气管插管-肺表面活性物质(PS)-拔管后行经鼻持续气道正压通气(NCPAP),LISA组在NCPAP下经直接喉镜直视下向气管内置入5F胃管并注入PS。比较两组患儿给药过程中情况、预后及晚期结局。结果:给药过程中,LISA组患儿生后72 h气管插管机械通气比例、心动过缓、SpO2降低、再次使用PS的发生率均较INSURE组低,差异均有统计学意义(P<0.05);LISA组需氧、无创通气及住院时间均短于INSURE组,差异均有统计学意义(P<0.05);LISA组BPD、IVH、ROP、气胸发生率均略低于INSURE组,但差异均无统计学意义(P>0.05)。结论:在治疗早产儿RDS过程中使用LISA技术,可有效降低并发症,缓解因反复气管插管给药而引起的不良反应,利于患儿预后。Objective:To analyze the efficacy of modified INSURE technique in the treatment of respiratory distress syndrome(RDS)in premature infants.Method:Sixty-eight premature infants with RDS admitted to our hospital from June 2018 to June 2019 were enrolled in the study.They were divided into INSURE group(n=34)and LISA group(n=34)by random number table method.The INSURE group adopts endotracheal intubation-pulmonary surfactant(PS)-nasal continuous positive airway pressure(NCPAP)was performed after unplugging,and the LISA group adopts 5F gastric tube was inserted into the trachea through direct laryngoscope under NCPAP and PS was injected.The conditions,prognosis and late outcomes were compared between two groups.Result:During the administration,the proportion of mechanical ventilation 72 h after birth,bradycardia,SpO2 decreased and the incidence of re-use of PS in the LISA group were lower than those in the INSURE group,the differences were statistically significant(P<0.05).The incidence of aerobic,non-invasive ventilation and hospitalization in the LISA group were shorter than those in the INSURE group(P<0.05).The incidence of BPD,IVH,ROP and pneumothorax in the LISA group were slightly lower than those in the INSURE group,but the differences were not statistically significant(P>0.05).Conclusion:The use of LISA in the treatment of premature infants with RDS can effectively reduce the complications,relieve the adverse reactions caused by repeated tracheal intubation,and benefit the prognosis of children.

关 键 词：呼吸窘迫综合征 早产儿 改良INSURE 技术 预后 

分 类 号：R722.6[医药卫生—儿科]