LISA与INSRUE两种给药方式对极低体质量儿呼吸窘迫综合征应用的效果评价  

Effect evaluation of less invasive surfactant administration and intubation surfactant exudation on respiratory distress syndrome in infants with very low birth weight

作　　者：付利珍 刘真真 张先红[1] Fu Lizhen;Liu Zhenzhen;Zhang Xianhong(Neonatal Diagnosis and Treatment Center,Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics)

机构地区：[1]重庆医科大学附属儿童医院新生儿诊治中心、国家儿童健康与疾病临床医学研究中心、儿童发育疾病研究教育部重点实验室、儿科学重庆市重点实验室,重庆400014

出　　处：《重庆医科大学学报》2022年第5期590-595,共6页Journal of Chongqing Medical University

基　　金：2019年重庆医科大学附属儿童医院医疗新技术资助项目(编号:[2019]285)

摘　　要：目的:探讨细管(less invasive surfactant administration,LISA)与气管插管(intubation surfactant exudation,INSURE)2种给药方式注入肺表面活性物质(pulmonary surfactant,PS)治疗极低体质量儿呼吸窘迫综合征的效果评价。方法:选取2018年2月至2020年3月重庆医科大学附属儿童医院新生儿重症监护治疗病房(neonatal intensive care unit,NICU)收治的极低体质量儿呼吸窘迫综合征110例为研究对象,根据住院号尾号单双号分为对照组和观察组。其中对照组56例采取INSURE技术,观察组54例采取LISA技术。回顾性分析2组患儿插管一次性成功率、药液反流、PS再次使用率、72 h内机械通气率、机械通气时间、持续气道正压通气(continuous positive airway pressure,CPAP)使用时间、用氧时间、住院时间及住院费用等的差异。结果:在技术操作中,观察组插管一次性成功率高于对照组[98.15%(53/54)vs.85.71%(48/56),P=0.042]。在治疗过程中,观察组平均吸氧浓度(fraction of inspiration O_(2),FiO_(2))、心动过缓发生率、72 h内重新气管插管率低于对照组,差异均有统计学意义(P<0.05)。机械通气使用率对照组高于观察组[30.36%(17/56)vs.12.96%(7/54),P=0.027]。平均住院费用对照组[(99720.23±37356.95)元]高于观察组[(85630.83±34110.20)元],差异有统计学意义(P=0.041)。结论:气管内给予PS治疗极低体质量儿呼吸窘迫综合征,LISA技术优于INSRUE技术。Objective:To discuss the effect of less invasive surfactant administration(LISA)and intubation surfactant exudation(INSURE)to inject pulmonary surfactant(PS)on respiratory distress syndrome in infants with very low birth weight.Methods:A total of 110 cases of very low birth weight infants with respiratory distress syndrome admitted to NICU(neonatal intensive care unit)of Children's Hospital of Chongqing Medical University from February 2018 to March 2020 were selected as the research objects,and they were divided into control group and observation group according to the single and double numbers of hospitalization number.Among them,56 cases in control group applied INSURE technique,and 54 cases in observation group applied LISA technique.The differences of one-time success of intubation,medication reflux,PS medication reuse rate,72 h mechanical ventilation rate,mechanical ventilation time,continuous positive airway pressure(CPAP)duration,oxygen time,hospitalization time and hospitalization expenses between the two groups were analyzed retrospectively.Results:In this technique operation,one-time success rate of intubation in the observation group was higher than that in the control group[98.15%(53/54)vs.85.71%(48/56),P=0.042].In the course of treatment,the average of fraction of inspiration O_(2)(FiO_(2)),incidence of bradycardia,and rate of re-tracheal intubation within 72 hours in observation group were lower than those in control group,with significant differences(P<0.05).The utilization rate of mechanical ventilation in control group was higher than that in observation group[30.36%(17/56)vs.12.96%(7/54),P=0.027].The average hospitalization expenses in control group[(99720.23±37356.95)yuan]were higher than those in observation group[(85630.83±34110.20)yuan],with significant differences(P=0.041).Conclusion:The LISA technique is superior to INSURE technique in the treatment of respiratory distress syndrome in very low weight infants.

关 键 词：极低体质量儿 呼吸窘迫综合征 细管 气管插管 

分 类 号：R47[医药卫生—护理学]