微侵入气管内注入肺表面活性物质在新生儿呼吸窘迫综合征的应用研究  

Application research of less invasive surfactant administration of pulmonary surfactant in neonatal respiratory distress syndrome

作　　者：杨磊 袁水生 胡小华 罗勇 黄菁娟 YANG Lei;YUAN Shuisheng;HU Xiaohua;LUO Yong;HUANG Jingjuan(Neonatology Department of Maternal and Child Health Care Hospital of Xinyu,Jiangxi 338000,China)

机构地区：[1]江西省新余市妇幼保健院新生儿科,新余338000

出　　处：《上海医药》2024年第2期34-38,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：2022年度江西省卫生健康委员会科技计划项目(202212252)。

摘　　要：目的:探讨微侵入气管内注入PS(LISA技术)在新生儿呼吸窘迫综合征(RDS)的应用价值。方法:选取2020年5月至2022年5月新生儿监护室收治的80例早产儿进行前瞻性研究。用随机数字表法将患儿分为INSURE组和LISA组各40例,分别应用INSURE技术和LISA技术。观察两组插管所需时间、给药时间、机械通气时间、氧疗时间、住院时间、氧动力学指标和不良反应发生情况。结果:LISA组插管所需时间、给药时间均短于INSURE组(P<0.05)。LISA组和INSURE组机械通气时间、氧疗时间对比差异无统计学意义(P>0.05)。LISA组的住院时间短于INSURE组(P<0.05)。LISA组和INSURE组干预前PaO_(2)、PaCO_(2)、氧合指数对比差异无统计学意义(P>0.05)。LISA组和INSURE组干预后PaO_(2)、氧合指数高于干预前,PaCO_(2)低于干预前(P<0.05)。干预后LISA组PaO_(2)、氧合指数高于INSURE组,PaCO_(2)低于INSURE组(P<0.05)。LISA组不良反应总发生率为5%(2/40),低于INSURE组的45%(18/40,P<0.05)。结论:LISA技术在新生儿RDS中的应用效果较好,可以缩短患儿的插管所需时间、给药时间、住院时间,改善氧动力学指标,不影响患儿的机械通气时间、氧疗时间,可减少不良反应的发生。Objective:To investigate the application value of less invasive surfactant administration(LISA)of pulmonary surfactant(PS)in neonatal respiratory distress syndrome(RDS).Methods:From May 2020 to May 2022,80 premature infants admitted to Newborn Care Unit were selected for prospective study.The patients were randomly divided into an intubationsurfactant-extubation(INSURE)group and a LISA group with 40 cases in each group with random number table method,and INSURE technology and LISA technology were adopted,respectively.The times needed for intubation,administration,mechanical ventilation,oxygen therapy,hospitalization,oxygen kinetics index and adverse reactions were observed.Results:The times of intubation and drug administration in the LISA group were shorter than those in the INSURE group(P<0.05).There were no significant differences in mechanical ventilation time and oxygen therapy time between the LISA group and the INSURE group(P>0.05).The hospitalization time in the LISA group was shorter than that in the INSURE group(P<0.05).There was no significant difference in PaO_(2),PaCO_(2)and oxygenation index between the LISA group and the INSURE group before intervention(P>0.05).After intervention,PaO_(2)and oxygenation index in the LISA group and the INSURE group were higher than those before intervention,and PaCO_(2)was lower than those before intervention(P<0.05).After intervention,PaO_(2)and oxygenation index in the LISA group were higher than those in the INSURE group,and PaCO_(2)in the LISA group was lower than those in the INSURE group(P<0.05).The total incidence of adverse reactions in the LISA group was 5%(2/40)lower than that 45%(18/40)in the INSURE group(P<0.05).Conclusion:The application of LISA technology in neonatal RDS has a good effect,can shorten the intubation time,drug administration time and hospitalization time of children,improve the oxygen dynamics index,does not affect the mechanical ventilation time and oxygen therapy time of children,and reduces the occurrence of adverse reactions.

关 键 词：呼吸窘迫综合征 微侵入气管内注入PS 新生儿 

分 类 号：R722.1[医药卫生—儿科]