LISA技术对新生儿呼吸窘迫综合征患儿肺功能、血气指标及炎症因子的影响  

Impacts of LISA technology on lung function,blood gas indicators,and inflammatory factors in children with neonatal respiratory distress syndrome

作　　者：吴英丽[1] 张磊 张海鲲[1] 王玉霞[2] 赵明明 王丹旗 WU Yingli;ZHANG Lei;ZHANG Haikun;WANG Yuxia;ZHAO Mingming;WANG Danqi(Department of Neonatology and Pediatrics,Weifang Maternal and Child Health Hospital,Weifang Shandong 261000,China)

机构地区：[1]潍坊市妇幼保健院新生儿科,山东潍坊261000 [2]潍坊市妇幼保健院眼科,山东潍坊261000

出　　处：《中国急救复苏与灾害医学杂志》2024年第5期663-666,672,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：潍坊市卫生健康委员会科研项目计划(编号:WFWSJK-2021-170)。

摘　　要：目的探讨微创注入肺表面活性物质(LISA)技术对新生儿呼吸窘迫综合征(NRDS)患儿肺功能、血气指标及炎症因子的影响。方法选择潍坊市妇幼保健院新生儿科重症监护病房(NICU)2021年1月—2023年1月收治的80例NRDS患儿为研究对象,依照随机数字表法分成传统组(n=40)和LISA组(n=40)。传统组应用气管插管-肺表面活性物质给药-拔管(INSURE)技术治疗,LISA组采取LISA技术治疗。比较两组治疗前、治疗72 h后血气指标、炎症因子水平、肺功能,同时比较两组治疗相关指标、并发症情况及28 d病死率。结果治疗72 h后,两组动脉血二氧化碳分压(PaCO_(2))、血清超敏C反应蛋白(hs-CRP)、巨噬细胞移动抑制因子-1(MIF-1)水平均低于治疗前(P<0.05),且LISA组上述3项指标均明显低于传统组(P<0.05);治疗72 h后,两组动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))、白介素10(IL-10)水平、氧合指数(OI)、呼吸频率(RR)测定值均高于治疗前(P<0.05),且LISA组上述指标均明显高于传统组(P<0.05);LISA组72 h内机械通气率低于传统组(P<0.05),机械通气时间、氧疗时间、NICU入住天数、住院天数短于传统组(P<0.05),支气管肺发育不良(BPD)发生率(5.00%)低于传统组的20.00%(P<0.05);LISA组28 d病死率5.00%和传统组的12.50%比较无统计学差异(P>0.05)。结论对NRDS患儿采用LISA技术治疗,可有效改善血气指标、炎症状况,明显缩短氧疗时间及住院天数,显著提高肺功能,并有助于降低BPD发生风险。Objective To explore the impacts of less invasive surfactant administration(LISA)technology on lung function,blood gas indicators,and inflammatory factors in children with neonatal respiratory distress syndrome(NRDS).Methods Eighty children with NRDS admitted to the neonatal intensive care unit(NICU)of Weifang Maternal and Child Health Hospital from January 2021 to January 2023 were collected as the study subjects,and were randomly grouped into a traditional group(n=40)and a LISA group(n=40)according to the random number table method.The traditional group was treated with intubation-surfactant-extubation(INSURE),while the LISA group was treated with LISA technology.Blood gas indicators,inflammatory factor levels,and lung function were compared between the two groups before and after 72 hours of treatment,meantime,treatment related indicators,complications and 28-day mortality rate were compared between the two groups.Results After 72 hours of treatment,the levels of arterial blood partial pressure of carbon dioxide(PaCO_(2)),serum high-sensitivity C-reactive protein(hs-CRP)and macrophage migration inhibitory factor-1(MIF-1)in both groups were lower than those before treatment(P<0.05),and the above three indicators in the LISA group were obviously lower than those in the traditional group(P<0.05);after 72 hours of treatment,the measured values of arterial partial pressure of oxygen(PaO_(2)),oxygen saturation(SpO_(2)),interleukin-10(IL-10),oxygenation index(OI)and respiratory rate(RR)in both groups were higher than those before treatment(P<0.05),and the above indicators in the LISA group were obviously higher than those in the traditional group(P<0.05);the mechanical ventilation rate within 72 hours in the LISA group was lower than that in the traditional group(P<0.05),mechanical ventilation time,the duration of oxygen therapy,NICU stay days and hospitalization days were shorter than those in the traditional group(P<0.05),the incidence of bronchopulmonary dysplasia(BPD)5.00%was lower than the 20.00%in the tradition

关 键 词：微创注入肺表面活性物质 呼吸窘迫综合征 肺功能 血气指标 炎症因子 新生儿 

分 类 号：R712.13[医药卫生—妇产科学]