经鼻双水平正压通气联合经细管肺表面活性物质注入技术治疗早产儿呼吸窘迫综合征的临床疗效  

Clinical Efficacy of Nasal Duo Positive Airway Pressure Combined with Less Invasive Pulmonary Surfactant Administration Technique in the Treatment of Premature Infants with Respiratory Distress Syndrome

作　　者：刘艳红[1] 梁桂娟[1] 贾美云[1] 李远征[1] 康珈宁 张会敏 闫安平[1] Liu Yanhong;Liang Guijuan;Jia Meiyun;Li Yuanzheng;Kang Jianing;Zhang Huimin;Yan Anping(Zhengzhou People’s Hospital,Henan Zhengzhou 450000,China)

机构地区：[1]郑州人民医院,河南郑州450000

出　　处：《儿科药学杂志》2021年第12期6-9,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨经鼻双水平正压通气(DuoPAP)联合不同时间点经细管肺表面活性物质(PS)注入技术(LISA)治疗早产儿呼吸窘迫综合征(RDS)的临床疗效。方法:选取2017年6月至2018年6月郑州人民医院收治的RDS早产儿58例,按随机数表法分为早期LISA组(n=30)及补救性LISA组(n=28)。早期LISA组给予DuoPAP辅助呼吸,将胃管置入气管内,PS缓慢经胃管注入,注入时由DuoPAP辅助呼吸,注入完毕后拔出胃管,继续DuoPAP辅助呼吸;补救性LISA组患儿给予DuoPAP辅助呼吸,若出现呼吸困难进行性加重,将胃管置入气管内,补救性将PS缓慢经胃管注入,注入完毕后拔出胃管,继续DuoPAP辅助呼吸,比较两组患儿需要机械通气的比例、住院时间、住院费用,记录气胸、肺炎、支气管肺发育不良(BPD)和颅内出血(ICH)发生率。结果:两组患儿机械通气需求比例、无创通气时间、肺炎发生率、住院时间、气胸、BPD及ICH发生率等比较差异均无统计学意义(P>0.05)。补救性LISA组住院费用低于早期LISA组,差异有统计学意义(P<0.05)。结论:采用经鼻双水平正压通气联合补救性LISA技术可有效缓解呼吸窘迫,降低住院费用,且未增加气漏、BPD、颅内出血发生率,未延长住院时间。Objective:To probe into the clinical efficacy of nasal duo positive airway pressure(DuoPAP)combined with less invasive pulmonary surfactant(PS)administration(LISA)technique at different time points in the treatment of premature infants with respiratory distress syndrome(RDS).Methods:A total of 58 premature infants with RDS admitted into Zhengzhou People’s Hospital from Jun.2017 to Jun.2018 were extracted to be divided into the early LISA group(n=30)and the remedial LISA group(n=28)via the random number table.In the early LISA group,DuoPAP was given,the gastric tube was placed into the trachea,PS was slowly injected through the gastric tube,DuoPAP was given during the injection,and the gastric tube was removed and DuoPAP was continued after the injection was completed.Children in the remedial LISA group were given DuoPAP,if progressive worsening dyspnea occurred,the gastric tube was placed into the trachea,and PS was slowly injected through the gastric tube remedially,the gastric tube was removed and DuoPAP was continued after the injection was completed.The proportion of children requiring mechanical ventilation,length of stay and hospitalization costs were compared between two groups,and the incidences of pneumothorax,pneumonia,bronchopulmonary dysplasia(BPD)and intracranial hemorrhage(ICH)were recorded.Results:There were no statistically significant differences between two groups in the proportion of children requiring mechanical ventilation,duration of noninvasive ventilation,incidence of pneumonia,length of stay,incidence of pneumothorax,BPD and ICH(P>0.05).The hospitalization costs of the remedial LISA group were lower than those of the early LISA group,the difference was statistically significant(P<0.05).Conclusion:DuoPAP combined with LISA technique can effectively relieve the respiratory distress,reduce the hospitalization costs,and do not increase the incidence of air leakage,BPD,intracranial hemorrhage,and prolong the length of stay.

关 键 词：微创注入肺表面活性物质治疗技术 呼吸窘迫综合征 早产儿 

分 类 号：R725.6[医药卫生—儿科]