振荡筛网雾化肺表面活性物质给药在新生儿呼吸窘迫综合征气管插管呼吸支持治疗中的应用  

Application of vibrating mesh aerosolized pulmonary surfactants administration in tracheal intubation respiratory support treatment for neonatal respiratory distress syndrome

作　　者：谢月娥[1] 蒋美兰 周丽芳[1] 刘远威 曹慧春 唐迎元[2] 李芬[1] XIE Yue'e;JIANG Meilan;ZHOU Lifang;LIU Yuanwei;CAO Huichun;TANG Yingyuan;LI Fen(Neonatal Intensive Care Unit,Chenzhou First People's Hospital,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院新生儿重症监护科,湖南郴州423000 [2]郴州市第一人民医院儿童呼吸科二区,湖南郴州423000

出　　处：《山东医药》2025年第1期109-113,共5页Shandong Medical Journal

基　　金：湖南省郴州市早产儿慢性肺病管理技术研发中心项目;湖南省郴州市超早产儿/超低出生体重儿综合救治管理技术研发中心项目;湘南学院校级课题医院联合项目(2020XJ121)。

摘　　要：目的探讨振荡筛网雾化肺表面活性物质(PS)在新生儿呼吸窘迫综合征(NRDS)需气管插管呼吸支持患儿中的临床疗效及应用价值,为气管插管下NRDS患儿PS的最佳使用方式提供参考。方法选择需气管插管呼吸支持的NRDS患儿43例,按照PS给药方法分为实验组12例、对照组31例。对照组采用传统方式滴入PS给药,实验组采用振荡筛网雾化PS给药。观察并比较两组PS使用前后1 h内脑氧饱和度、心率及血氧饱和度变化情况以及PS的使用次数、插管次数、有创呼吸机使用时间、无创呼吸机使用时间、空氧时间及总用氧时间,纠正胎龄36周中支气管肺发育不良(BPD)、重度BPD、血流动力学意义的动脉导管未闭(hsPDA)、早产儿视网膜病(ROP)、新生儿坏死性小肠结肠炎(NEC)Ⅱ期及以上、脑室周围-脑室内出血(PIVH)3级及以上、肺出血、肺部漏气发生情况。计算并比较两组BPD患儿有创机械通气、无创辅助通气及空氧混合吸入天数的构成比。结果两组脑氧饱和度下降比例、心率下降比例及血氧饱和度下降比例、PS使用次数、插管次数、有创呼吸机使用时间、无创呼吸机使用时间、总用氧时间以及各并发症发生率比较差异均无统计学意义(P均>0.05)。实验组有创机械通气天数构成比低于对照组(P<0.05)。结论振荡筛网雾化PS可减少进展为BPD的NRDS患儿对有创通气的需求,临床疗效较好且安全性较高。Objective To investigate the clinical efficacy and application value of vibrating mesh aerosolized pulmonary surfactants(PS)in newborn respiratory distress syndrome(NRDS)patients requiring tracheal intubation respiratory support,in order to provide reference for the best use of PS in newborns with NRDS under invasive respiratory support.Methods Forty-three preterm infants with NRDS in need of tracheal intubation respiratory support were divided into the experimental group(12 cases)and control group(31 cases)according to the method of PS administration.The control group was administered PS drops by traditional method,while the experimental group was administered PS atomized by vibrating mesh atomization technique.The changes of cerebral oxygen saturation,heart rate and blood oxygen saturation within 1 h before and after PS use,the times of PS use,intubation times,invasive ventilator time,non-invasive ventilator time,air oxygen mixer time,total oxygen time,the occurrence of bronchopulmonary dysplasia(BPD)in 36 weeks of corrected gestational age,severe BPD,hemodynamically significant patent ductus arteriosus(hsPDA),retinopathy of prematurity(ROP),neonatal necrotizing enterocolitis(NEC)stageⅡand above,periventricular to intraventricular hemorrhage(PIVH)grade 3 and above,pulmonary hemorrhage,and pulmonary air leakage were observed and compared between the two groups.The composition ratio of invasive mechanical ventilation,non-invasive assisted ventilation and combined air-oxygen inhalation days in BPD children were calculated.Results There were no significant differences in the proportion of decreased cerebral oxygen saturation,the proportion of decreased heart rate and the proportion of decreased blood oxygen saturation,the times of PS use,the times of intubation,the time of invasive ventilator use,the time of non-invasive ventilator use,the total oxygen use time or the incidence of complications between the two groups(all P>0.05).The proportion of invasive mechanical ventilation days in the experimental group was

关 键 词：新生儿呼吸窘迫综合征 肺泡表面活性物质 振荡筛网雾化技术 有创机械通气 早产儿 

分 类 号：R722.6[医药卫生—儿科]