LISA技术联合喉罩气道正压通气滴入肺泡表面活性物质对NRDS患儿PO2、PCO2的影响  

Effects of LISA combined with positive laryngeal mask airway pressure into alveolar surfactant on PO2 and PCO2 in neonates with NRDS

作　　者：钟小明[1] ZHONG Xiao-ming(Department of Neonatal Medicine of the First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院第一附属医院新生儿科,江西赣州341000

出　　处：《赣南医学院学报》2020年第12期1209-1212,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市卫生计划与生育委员会课题(编号:2016-1-7)。

摘　　要：目的:探讨微创表面活性物质给药技术(less invasive surfactant administration,LISA)联合喉罩气道正压通气滴入肺泡表面活性物质(pulmonary surfactant,PS)对新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)患儿PO2、PCO2的影响。方法:采用随机数字表法将2017年3月至2018年9月在我院新生儿科住院NRDS早产患儿38例随机分成对照组(16例)和喉罩通气道组(22例),对照组用Magill钳持6F无菌胃管置入气道,滴入肺泡表面活性物质(200 mg·kg^-1);喉罩通气道组在对照组的基础上,在滴入肺泡表面活性物质时予喉罩气道正压通气,比较两组治疗后3 h、24 h PO2、PCO2值及不良反应发生率。结果:治疗后3 h,喉罩通气道组PO2高于对照组,差异有统计学意义(P<0.05);其他时间点两组PO2、PCO2值比较,差异无统计学意义(P>0.05)。喉罩通气道组肺泡表面活性物质返流发生率低于对照组,差异有统计学意义(P<0.05);两组肺炎、颅内出血、支气管肺发育不良发生率比较,差异无统计学意义(P>0.05)。结论:LISA技术联合喉罩气道正压通气滴入肺泡表面活性物质能够迅速改善患儿氧合,并降低肺泡表面活性物质返流的发生率。Objective:To investigate the effects of LISA combined with laryngeal mask airway positive pressure ventilation on PO2 and PCO2 in neonates with NRDS.Methods:The random number table method was used to divide 38 cases of NRDS premature neonates who admitted to the neonatal department of the First Affiliated Hospital of Gannan Medical University from March 2017 to September 2018 into the control group(16 cases)and the LMA group(22 cases)randomly.The control group was placed into the airway with a 6F sterile gastric tube with Magill forceps,and the PS(200 mg·kg^-1)was dripped into the control group.Based on the way of the control group,the LMA group was positively ventilated with laryngeal mask airway pressure when the PS was dropped.Compare PO2 and PCO2 value and incidence of adverse reactions after treatment 3 h,24 h between two groups.Results:After 3 hours treatment,PO2 in the LMA group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the PO2 and PCO2 values between the two groups after 24 hours(P>0.05).The incidence of PS reflux in the LMA group was lower than that in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in the incidence of pneumonia,intracranial hemorrhage,and bronchopulmonary dysplasia between the two groups(P>0.05).Conclusion:LISA combined with laryngeal mask airway positive pressure ventilation into alveolar surfactant can rapidly improve the oxygenation of children and reduce the incidence of PS reflux.

关 键 词：喉罩气道 微创表面活性物质给药技术 肺泡表面活性物质 氧分压 二氧化碳分压 

分 类 号：R725.6[医药卫生—儿科]