经微创表面活性剂给药技术联合经鼻间歇正压通气治疗极低出生体重早产儿呼吸窘迫综合征的疗效  

Clinical observation of LISA technology combined with NIPPV in the treatment of respiratory distress syndrome of very low birth weight premature infants

作　　者：杨欣 陈北洋 朱小丽 YANG Xin;CHEN Bei-Yang;ZHU Xiao-Li(Department of Neonatology,First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,Jiangxi,China)

机构地区：[1]赣南医科大学第一附属医院新生儿科,江西赣州341000 [2]瑞金市妇幼保健院

出　　处：《吉林医学》2025年第3期653-656,共4页Jilin Medical Journal

基　　金：江西省卫生健康委科技计划项目[项目编号:202310794]。

摘　　要：目的:探讨经微创表面活性剂给药技术(LISA)联合经鼻间歇正压通气(NIPPV)治疗极低体重早产儿呼吸窘迫综合征(ARDS)的疗效。方法:随机选取2022年7月~2024年5月于赣南医科大学第一附属医院出生的50例ARDS患儿为研究对象,分为对照组[n=25,LISA联合经鼻持续气道正压(nCPAP)治疗]与研究组(n=25,LISA联合NIPPV治疗),分析治疗后两组主要观察指标。结果:与治疗前比较,两组患儿血pH值、动脉血氧分压(PaO_(2))均上升,动脉血二氧化碳分压(PaCO_(2))均降低,且研究组血pH值、PaO_(2)高于对照组,PaCO_(2)低于对照组,差异均有统计学意义(均P<0.05);治疗后两组患儿再次应用细导管注入肺表面活性物质(PS)率,呼吸暂停发生率、72 h内有创机械通气率、无创通气时间等比较,研究组显著低于对照组,差异均有统计学意义(均P<0.05);两组脑室内出血(IVH)及支气管肺发育不良(BPD)发生率比较,差异均无统计学意义(均P>0.05)。结论:在极低体重早产儿ARDS治疗中,LISA技术联合NIPPV应用效果理想,可改善患儿血气分析指标,降低其有创呼吸支持风险,安全性好。Objective To investigate the efficacy of minimally invasive surfactant administration technology(LISA)combined with transnasal intermittent positive pressure ventilation(NIPPV)in the treatment of respiratory distress syndrome(RDS)in very low-body weight preterm infants.Methods According to the random number table method,50 children with respiratory distress syndrome born in the first affiliated hospital of Gannan medical university from July 2022 to May 2024 were divided into control group[n=25,LISA combined with nasal continuous positive airway pressure(nCPAP)]and a study group(n=25,LISA combined with NIPPV).Main observation indicators were analyzed after treatment.Results Compared with before treatment,blood pH and arterial oxygen partial pressure(PaO_(2))increased,while arterial carbon dioxide partial pressure(PaCO_(2))decreased in both groups(P<0.05).After treatment,blood pH and PaO_(2) were significantly higher,and PaCO_(2) was significantly lower in the study group than in the control group(P<0.05).The incidence of reapplication of pulmonary surfactant via thin catheter,apnea,invasive mechanical ventilation within 72 hours,and duration of non-invasive ventilation were significantly lower in the study group than in the control group(P<0.05).There were no significant differences in the incidence of intraventricular hemorrhage(IVH)and bronchopulmonary dysplasia(BPD)between the two groups(P>0.05).Conclusions In the treatment of RDS in very low body weight premature infants,LISA technology combined with NIPPV has an ideal effect,can improve blood gas analysis indices,reducing the risk of invasive respiratory support,and is highly safe,making it worthy of clinical promotion.

关 键 词：LISA技术 经鼻间歇正压通气 极低出生体重 呼吸窘迫综合征 

分 类 号：R722.6[医药卫生—儿科]