LISA技术在呼吸窘迫综合征的早产儿应用中的临床研究  

Clinical Study on the Application of LISA Technique in Preterm Infants with respiratory distress syndrome

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

机构地区：[1]江苏省镇江市丹阳市妇幼保健院新生儿科,江苏丹阳212300

出　　处：《中外医疗》2023年第4期104-108,113,共6页China & Foreign Medical Treatment

基　　金：镇江市科技计划项目(SH2020054)。

摘　　要：目的探讨胃管微创注入肺表面活性物质(less invasive surfactant administration,LISA)技术在呼吸窘迫综合征的早产儿应用中的临床效果。方法选取2019年1月—2021年12月江苏省镇江市丹阳市妇幼保健院新生儿科收治的胎龄在34周内的呼吸窘迫综合征的早产儿50例为研究对象,随机数表法分为两组,每组25例。对照组患儿使用气管插管-肺表面活性物质-拔管法治疗,观察组患儿使用LISA技术。比较两组患儿治疗前和治疗第1周的血气指标变化(pH值、PaCO_(2)、PaO_(2)及PaO_(2)/FiO_(2));检验检查次数;治疗与不良事件发生情况、住院天数、住院费用、静脉输注总瓶数及出院体质量等。结果治疗后,两组患儿的pH值、PaO_(2)及PaO_(2)/FiO_(2)均升高,且观察组的pH值(7.43±0.21)明显高于对照组,差异有统计学意义(t=2.295,P=0.026);治疗后,观察组PaCO_(2)(38.58±7.12)mmHg明显低于对照组,差异有统计学意义(t=2.553,P=0.014)。与对照组相比,观察组患儿在治疗的第1周内影像学检查、血气分析及血液学检查次数明显降低,首次使用肺表面活性物质明显下降,累积使用量明显增加,机械通气例数、强心剂使用例数及抗生素使用天数明显减少,红细胞输血量明显减少,肠内喂养情况明显好转,差异有统计学意义(P<0.05)。观察组不良事件发生率、住院时间、住院费用及静脉输注总瓶数均明显低于对照组,差异有统计学意义(P<0.05)。结论LISA技术可改善治疗第1周内患儿的呼吸通气,显著减少患儿有创性及辐射性检查检验次数。Objective To investigate the clinical effects of the minimally invasive surfactant administration(LISA)technique in preterm infants with respiratory distress syndrome.Methods Fifty preterm infants with respiratory distress syndrome with gestational age within 34 weeks admitted to the Department of Neonatology in Danyang Maternal and Child Health Hospital,Zhenjiang,Jiangsu Province from January 2019 to December 2021 were selected as the study subjects and divided into two groups by random number table method,25 cases in each group,and the children in the control group were treated by tracheal intubation-pulmonary surface active substance-extubation method,while the patients in the observation group were treated by LISA method.Blood gas indexes(pH value,PaCO_(2),PaO_(2) and PaO_(2)/FiO_(2)),the number of tests,treatment and adverse events,hospitalization days,hospitalization costs,total number of intravenous infusion bottles and discharged body mass of the two groups were compared before treatment and at the first week of treatment.Results After treatment,the pH value,PaO_(2) and PaO_(2)/FiO_(2) in both groups were increased,and the pH value in the observation group(7.43±0.21)was significantly higher than that in the control group,the difference was statistically significant(t=2.295,P=0.026).After treatment,PaCO_(2)(38.58±7.12)mmHg in the observation group was significantly lower than that in the control group,the difference was statistically significant(t=2.553,P=0.014).In the first week of treatment,compared with the control group,the number of imaging examination,blood gas analysis and hematology examination in the observation group was significantly decreased,the first use of pulmonary surfactant was significantly decreased,the cumulative use was significantly increased,the number of cases of mechanical ventilation,the number of cases of cardiac enhancement and the days of antibiotic use were significantly decreased,the amount of red blood cell transfusion was significantly decreased,and the enteral feeding s

关 键 词：肺表面活性物质 LISA 气管插管-给药-拔管 治疗 

分 类 号：R722[医药卫生—儿科]