LISA技术治疗早产儿呼吸窘迫综合征的临床研究  

Clinical Study of LISA Technique for the Treatment of Respiratory Distress Syndrome in Premature Infants

作　　者：刘琦 束辉玲 丁晓燕[1] LIU Qi;SHU Huiling;DING Xiaoyan(Department of Pediatrics,Danyang Maternal and Child Health Hospital,Danyang,Jiangsu Province,212300 China)

机构地区：[1]丹阳市妇幼保健院儿科,江苏丹阳212300

出　　处：《世界复合医学》2022年第12期41-44,共4页World Journal of Complex Medicine

基　　金：镇江市科技计划项目(SH2020054)。

摘　　要：目的 探讨对早产儿呼吸窘迫综合征采用经胃管气管内注入肺泡表面活性剂(less invasive surfactant administration,LISA)技术治疗的临床效果。方法 选择2020年1月—2021年12月丹阳市妇幼保健院收治的早产儿呼吸窘迫综合征患儿40例,以随机数表法分为气管插管-肺表面活性物质-拔管(intubation-surfactant-extubation,INSURE)技术治疗的对照组(n=20)与LISA技术治疗的观察组(n=20),比较两组治疗前后血气指标以及疾病相关指标,检测患儿治疗前后皮质醇(Cor)、促肾上腺皮质激素(ACTH)水平来评估应激反应,并统计两组并发症发生情况。结果 观察组治疗后氧分压(91.05±7.13)mmHg、氧合指数(271.12±30.48)mmol/L均高于对照组,二氧化碳分压(33.14±3.64)mmHg低于对照组,差异有统计学意义(t=6.280、5.044、7.902,P<0.05)。观察组辅助通气时间、用氧时间、住院时间分别为(82.25±7.24)h、(7.52±1.65)d、(20.52±4.43)d,均短于对照组,差异有统计学意义(t=5.219、2.555、3.680,P<0.05)。观察组治疗后Cor、ACTH水平分别为(17.52±2.26)μg/dl、(36.16±2.43)pg/mL,均低于对照组,差异有统计学意义(t=3.736、5.137,P<0.05)。观察组并发症发生率低于对照组(5.00%vs 35.00%),差异有统计学意义(χ^(2)=3.906,P<0.05)。结论 LISA技术能改善早产儿呼吸窘迫综合征血气指标,可促进患儿康复,并可减轻应激反应,降低并发症发生风险。Objective To investigate the clinical effect of treatment of respiratory distress syndrome in preterm infants using the transgastric intratracheal infusion of alveolar surfactant(LISA)technique.Methods 40 cases of premature infants with respiratory distress syndrome admitted to the Danyang Maternal and Child Health Hospital from January 2020 to December 2021 were selected.They were divided into a control group(n=20)treated with the tracheal intubation-lung surfactant-extraction(INSURE)technique and an observation group(n=20)treated with the LISA technique by the random number table method.Blood gas indexes and disease-related indexes were compared between the two groups before and after treatment,cortisol(Cor)and adrenocorticotropic hormone(ACTH)levels were measured before and after treatment to assess the stress response,and the occurrence of complications in the two groups was counted.Results The partial pressure of oxygen(91.05±7.13)mmHg and oxygenation index(271.12±30.48)mmol/L in the observation group were higher than in the control group after treatment,the partial pressure of carbon dioxide(33.14±3.64)mmHg was lower than that of the control group,the difference was statistically significant(t=6.280,5.044,7.902,P<0.05).The duration of assisted ventilation,time on oxygen,and hospital stay in the observation group were(82.25±7.24)h,(7.52±1.65)d,and(20.52±4.43)d,respectively,which were shorter than those in the control group,the difference was statistically significant(t=5.219,2.555,3.680,P<0.05).The Cor and ACTH levels in the observation group were(17.52±2.26)μg/dl and(36.16±2.43)pg/mL,respectively, which were lower than those in the control group, the difference was statistically significant (t=3.736, 5.137, P<0.05). The complicationrate in the observation group was lower than that in the control group (5.00% vs 35.00%), the difference was statistically significant(χ^(2)=3.906, P<0.05). Conclusion LISA technique can improve the blood gas index of respiratory distress sign in preterm infants, can pr

关 键 词：早产儿 呼吸窘迫综合征 LISA技术 血气指标 并发症 

分 类 号：R722[医药卫生—儿科]