摘要
目的通过与传统气管插管-给药-拔管后使用正压通气(INSURE)技术比较,观察无创通气下应用胃管微创法注入肺表面活性物质(LISA)技术在防治新生儿呼吸窘迫综合征(NRDS)中的疗效。方法回顾性分析潍坊市人民医院新生儿科2014年12月~2015年2月住院治疗的88例NRDS患儿的临床资料,观察组34例,采用LISA技术,应用胃管插管进行滴注肺泡表面活性物质(PS),对照组50例,采用INSURE技术,应用传统气管插管滴注PS。记录各组患儿在给药过程中的心率、血氧饱和度、在院用氧时间及住院时间,统计两组患儿再次使用PS、呼吸暂停、机械通气、早期结局(气漏综合征、PPHN、PDA)及晚期结局(BPD,ROP,IVH,PVL)发生率等。记录患儿出院后1年内呼吸系统疾病发生率(上呼吸道感染发生率、支气管肺炎发生率、支气管肺炎治疗时间)。比较两组患儿各指标是否存在统计学差异。结果用药过程中LISA组患儿在血氧饱和度降低、心动过缓发生率均低于INSURE组(P<0.05);两组患儿给药后再次应用PS率、呼吸暂停率、机械通气率比较,差异无显著性(P>0.05);患儿治疗后早期结局、晚期结局中各并发症的发病率及预后比较,差异无显著性(P>0.05);两组患儿远期呼吸系统疾病相关指标(上呼吸道感染率、肺炎发生率、肺炎治疗时间),LISA组均低于INSURE组(P<0.05)。结论 LISA技术在临床治疗新生儿呼吸窘迫综合征有效,可降低给药过程中常规气管插管引起的并发症发生率,降低反复气管插管给药引起的气道及肺组织的损伤。
Objective To observe the effect of non-invasive ventilation on the expression of pulmonary surfactant in the treatment of non-invasive ventilation by intratumoral pressure technique in the prevention and treatment of neonatal respiratory distress syndrome. Methods Retrospective analysis of clinical data of 84 cases of NRDS children hospitalized in Neonatrics Department of Weifang People＇s Hospital from December 2014 to February 2015. Thirty-four cases of observation group were treated with LISA technique and using gastric tube intubation to drip pulmonary surfactant（ PS）. Fifty cases in the control group were treated with INSURE technique and traditional endotracheal intubation with PS. The heart rate and oxygen saturation during the course of administration were recorded. The duration of hospital use and the time of hospitalization were recorded. The incidence of PSV,apnea,mechanical ventilation,early outcome and late outcome in the two groups were statistically analyzed. The incidence of respiratory disease（ upper respiratory tract infection,pneumonia incidence,pneumonia treatment time） within one year after discharge were recorded. There was a statistically significant difference between the two groups. Results The incidence of bradycardia was lower in the LISA group than in the INSURE group（ P〈0. 05）. The patients in the LISA group were treated with PS rate,apnea rate（ P〈0. 05）. There was no significant difference between the two groups（ P〉0. 05）. There was no significant difference between the two groups（ P〈0. 05）. There was no significant difference between the two groups（ P〉0. 05）. Respiratory system diseases（ upper respiratory tract infection rate,pneumonia incidence,pneumonia treatment time）,LISA group were lower than INSURE group（ P〈0. 05）. Conclusion LISA technique is effective in the treatment of neonatal respiratory distress syndrome,which can reduce the complication rate caused by conventional tracheal intubation during administration. It can reduce the damage of airway and lung tissue caused by repeated tracheal intubation.
作者
郑家峰
孙璐双
王小静
刘伟
张俊杰
孟华夏
张立明
ZHENG Jiafeng1, SUN Lushuang1, WANG Xiaojing1, LIU Wei1, ZHANG Junjie1, MENG Huaxia1, ZHANG Liming2(1.Department of Pediatrics, Weifang Medical University, Weifang 261053, China ; 2. Department of Neonatology, Weifang People＇ s Hospita)
出处
《潍坊医学院学报》
2018年第1期24-27,共4页
Acta Academiae Medicinae Weifang
