罗红梅,袁晓庆,何丹,史勇军,石碧珍,陈兰,康颖倩,刘玲
LUO Hongmei,YUAN Xiaoqing,HE Dan,SHI Yongjun,SHI Bizhen,CHEN Lan,KANG Yingqian,LIU Ling

• 1:贵阳市妇幼保健院&贵阳市儿童医院新生儿科

摘要(Abstract)：

目的 比较微创植入肺泡表面活性物质(PS)治疗技术(Lisa)和气管插管-PS-快速拔管(Insure)对治疗早产儿呼吸窘迫综合征(NRDS)的疗效。方法 选择新生儿科胎龄<32周NRDS的早产儿采用Lisa(Lisa组)和Insure(Insure组)治疗，观察两组患儿使用PS前后30 min的血气情况[氧分压(PO_2)、二氧化碳分压(PCO_2)],两组患儿早产儿相关并发症、出院前死亡情况，使用PS后72 h内机械通气、二次使用PS、气漏、肺出血情况，以及两组患儿住院时间、需呼吸机时间、需氧时间；按胎龄31～32周、30～29周、27～28周、25～26周进行分层，分析两组不同胎龄患儿并发症的发生情况及住院、使用呼吸机和需氧时间。结果 Lisa组使用PS后72 h内需机械通气及二次使用PS的比例低于Insure组，差异具有统计学意义(P<0.05);但两组早产儿的相关并发症，住院、使用呼吸机及需氧时间，给药前后血气及出院前死亡率比较，差异均无统计学意义(P>0.05);Lisa组与Insure组不同胎龄患儿各种并发症发生率比较，差异无统计学意义(P>0.05);两组患儿以胎龄分层分析，住院时间、使用呼吸机及需氧时间比较，差异无统计学意义(P>0.05)。结论 Lisa技术给予PS治疗NRDS能降低72 h内机械通气及二次使用PS的比例，是一种较安全有效的方法。
Objective To compare the efficacy of minimally invasive implanted alveolar surfactant(PS) treatment techniques(Lisa) and endotracheal intubation-PS-rapid extubation(INSURE) for the treatment of respiratory distress syndrome(NRDS) in preterm infants. Methods Preterm infants with gestational age <32 weeks of NRDS were selected to be treated with Lisa(Lisa group) and Insure(Insure group), and Blood gases was observed for 30 min before and after PS in both groups. Related complications and death before discharge in the two groups were observed. Mechanical ventilation, secondary use of PS, air leakage, and pulmonary hemorrhage within 72 h of PS were observed, and hospitalization duration, ventilator requirement duration, and aerobic duration of children in both groups were observed. According to the gestational age of 31 to 32 weeks, 30 to 29 weeks, 27 to 28 weeks and 25 to 26 weeks, the complications and hospitalization, ventilator use and aerobic time of children with different gestational ages were analyzed. Results The proportion of 72 h domestic mechanical ventilation and secondary PS in the Lisa group was lower than the Insure group, and the difference was statistically significant(P<0.05). However, the two groups of related complications, hospitalization, ventilator use, aerobic time, blood gas and mortality before and after discharge were compared, and the differences were not statistically significant(P>0.05). The incidence of various complications in children with different gestational age in Lisa group and Insure group was compared, and the differences were not statistically significant(P>0.05). Gestational age stratified analysis, length of hospital stay, ventilator use and aerobic time of children in both groups were compared, and the differences were not statistically significant(P>0.05). Conclusion Lisa technology administration of PS treatment for NRDS can reduce the proportion of mechanical ventilation and secondary use of PS within 72 h, which is a more safe and effective method.

关键词(KeyWords)： 微创植入肺泡表面活性物质治疗技术;早产儿呼吸窘迫综合征;气管插管-PS-快速拔管技术;肺泡表面活性物质
less invasive surfactant administration;respiratory distress syndrome in preterm infants;intubation-surfactant-extubation technique;pulmonary surfactant

Abstract:

Keywords:

基金项目(Foundation): 贵州省高层次创新型人才项目(黔科合平台人才-GCC[2022]036-1);; 贵阳市科技计划项目(黔科合LH[2015]7034号)

作者(Author): 罗红梅,袁晓庆,何丹,史勇军,石碧珍,陈兰,康颖倩,刘玲
LUO Hongmei,YUAN Xiaoqing,HE Dan,SHI Yongjun,SHI Bizhen,CHEN Lan,KANG Yingqian,LIU Ling

DOI: 10.19367/j.cnki.2096-8388.2023.09.012

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