MIST与INSURE治疗早产儿呼吸窘迫综合征的疗效比较

Comparison on the curative effect of minimally MIST and INSURE in the treatment for premature infants with respiratory distress syndrome

目的观察经细管肺表面活性物质注入技术(MIST)与气管插管-使用肺表面活性物质-拔管使用持续气道正压通气技术(INSURE)治疗早产儿呼吸窘迫综合征(RDS)的临床疗效。方法选取2017年8月-2018年10月本院收治的108例RDS患儿作为研究对象,依据治疗方法不同将其分为对照组与观察组两组,每组各54例。对照组应用INSURE治疗,观察组应用MIST治疗,比较两组患儿临床治疗效果、用氧时间、住院时间、二次使用肺表面活性物质,并观察血气分析指标变化趋势与并发症发生情况。结果观察组治疗成功率为87.04%,显著高于对照组的66.67%(P<0.05);与对照组相比,治疗后观察组用氧时间、住院时间、二次使用肺表面活性物质均显著低于对照组(P<0.05),并且观察组动脉氧分压(PaO2)、动脉氧分压/吸入氧浓度比值(PaO2/Fi O2)显著高于对照组,动脉二氧化碳分压(PaCO2)、吸入氧浓度(Fi O2)显著低于对照组(P<0.05)。观察组患儿肺出血等并发症明显低于对照组(P<0.05)。结论RDS患儿采用MIST治疗可改善血气分析指标,促使肺功能有效恢复,预防并发症,尽早出院,治疗效果较INSURE技术优越,可作为临床首选救治措施。

Objective To observe the clinical efficacy of minimally invasive surfactant treatment(MIST)and intubate-surfactant-extubate technology under continuous positive airway pressure ventilation(INSURE)in the treatment for premature infants with respiratory distress syndrome(RDS).Methods 108 children with RDS treated in our hospital from August 2017 to October 2018 were divided into control group and observation group according to different treatment methods,the control group was treated with INSURE,and the observation group was treated with MIST.The clinical effects,oxygen consumption use time,hospitalization time and secondary use of pulmonary surfactant were compared between the two groups,the trend of blood gas analysis index and the incidence of complications were observed.Results The success rate of the observation group was 87.04%,which was significantly higher than that of the control group 66.67%(P<0.05);compared with the control group,the oxygen use time,hospitalization time and secondary use of pulmonary surfactant in the observation group were significantly lower than those in the control group(P<0.05);the arterial oxygen partial pressure(PaO2),arterial oxygen partial pressure/inhalation oxygen concentration ratio(PaO2/FiO2)in the observation group were significantly higher than those in the control group,arterial carbon dioxide partial pressure(PaCO2)and inhalation oxygen concentration(FiO2)were significantly lower than those in the control group(P<0.05);Complications such as pulmonary hemorrhage in the observation group were significantly lower than those in the control group(P<0.05).Conclusions MIST in the treatment of RDS children could improve blood gas analysis index,promote effective recovery of pulmonary function,prevent complications,and make the children discharge as soon as possible,the therapeutic effect of MIST is superior to INSURE technology,it could be used as the first choice of clinical treatment.