LISA技术在新生儿呼吸窘迫综合征中的应用

Application of LISA in Infants with Neonatal Respiratory Distress Syndrome

目的探讨微创肺表面活性物质应用技术(less invasive surfactant administration,LISA)在治疗新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)中的安全性及有效性。方法选择2019年5月~2021年5月收治的101例25~32周诊断NRDS的患儿为观察对象,随机分为LISA组(53例)与传统的气管插管-肺表面活性物质灌注-拔管(intubate-pulmonary surfactant administration-extubate,INSURE)组(48例),比较两种方法在治疗NRDS的效果。结果两组初始呼吸机参数要求、肺表面活性物质应用、72h内有创机械通气率、呼吸支持时间、各种并发症的发生率、平均住院时间的差异均无统计学意义(P>0.05)。在胎龄25~27周的研究对象中,LISA组支气管肺发育不良的发生率明显低于INSURE组(P<0.05)。结论LISA技术在NRDS的临床应用是安全有效的,并可改善部分患儿的临床结局,值得临床进一步深入研究。

Objective To explore the feasibility and potential benefits of less invasive surfactant administration(LISA)in infants with neonatal respiratory distress syndrome(NRDS)compared to conventional intubate-pulmonary surfactant(PS)administration-Extubate(INSURE).Methods All infants with respiratory distress born at 25-32 weeks′gestational age from May 2019 to May 2021(n=101),who were eligible for PS therapy were randomized to receive PS by LISA(n=53)or by INSRUE(n=48).Therapeutic effect of the two groups was compared.Results There were no statistically significant differences in the initial ventilator parameter requirements,PS application,invasive mechanical ventilation rate within 72 hours,respiratory support time,incidence of various complications,and average length of stay between the two groups(P>0.05).Among the subjects with a gestational age of 25-27 weeks,the incidence of bronchopulmonary dysplasia(BPD)in the LISA group was significantly lower than that in the INSURE group(P<0.05).Conclusion The clinical application of LISA in NRDS is safe and effective,and can improve the clinical outcome of some infants,it is worthy of further clinical trials.