INSURE技术与LISA技术对极早产儿呼吸窘迫综合征患者的疗效

The Effect of INSURE Technology and LISA Technology on Patients with Respiratory Distress Syndrome in Extremely Premature Infants

目的:对比插管-肺表面活性物质给药-拔管(INSURE)技术与微创肺表面活性物质给药(LISA)技术对极早产儿呼吸窘迫综合征患者的疗效。方法:选取2018年1月至2020年4月我院收治的108例极早产儿呼吸窘迫综合征患者作为研究对象,随机将其分为两组,对照组54例,给予INSURE技术治疗,研究组54例,给予LISA技术治疗。观察两组患儿治疗前后的血浆β-内啡肽(β-EP)、智力发展指数(MDI)、精神运动发育指数(PDI)水平,对比两组治疗过程中的指标、并发症、神经运动评价(纠正胎龄6月龄和12月龄的Gesell婴幼儿发育检查量表检测发育商DQ)及死亡率。结果:(1)两组患儿治疗后β-EP水平均下降,MDI、PD水均提高,研究组β-EP水平明显低于对照组,MDI、PD水平高于对照组(P<0.05)。(2)研究组患者反复呼吸暂停发生率明显优于对照组(P<0.05);两组对比,心动过缓、血氧饱和度(SpO_(2))降低、72 h内机械通气、再次使用肺泡表面活性物质(PS)等指标对比无差异(P>0.05);(3)两组患儿住院期间气胸、视网膜病变、脑室内出血(Ⅲ°或以上)、支气管肺发育不良等不良并发症和死亡率对比无差异(P>0.05)。(4)两组患儿在纠正胎龄6月龄和12月龄的5个能区评分和总发育商(DQ)比较无差异(P>0.05)。结论:LISA技术可减轻呼吸窘迫综合征极早产儿的神经发育损伤,亦能减少住院期间相关早产儿并发症,且对婴儿远期神经心理发育无不良影响,具有很好的临床价值,值得临床推广和应用。

Objective:To compare the effects of INSURE technology and LISA technology on patients with respiratory distress syndrome in very preterm infants.Methods:A total of 108 patients with extremely premature respiratory distress syndrome admitted to our hospital from January 2018 to April 2020 were selected as the research objects.They were randomly divided into two groups:control group(n=54) treated with INSURE technology,research group(n=54) treated with LISA technology.Observing two groups of patients before and after treatment serum beta-endorphin(beta EP),mental development index(MDI) and psychomotor development index(PDI)levels,compared with two groups of index,complications,neurological movement in the process of evaluation(correct gestational age 6months and 12 months of Gesell infant development check scale detecting developmental quotient DQ) and mortality.Results:(1) After treatment,the β-EP levels of the two groups of children decreased,and the levels of MDI and PD increased.The β-EP levels of the study group were lower than those of the control group,and the MDI and PD levels were higher than those of the control group(P0.05).(3)The comparison between the two groups of children during hospitalization of pneumothorax,retinopathy,intraventricular hemorrhage(Ⅲ° or above),bronchopulmonary dysplasia and other adverse complications and mortality rates were not difference(P>0.05).(4)There was no difference between the two groups of children in the five energy zone scores and the total development quotient DQ after correcting the 6-month and 12-month gestational age(P>0.05).Conclusion:LISA technology can alleviate the neurodevelopmental injury of extremely premature infants with respiratory distress syndrome and reduce related complications of premature infants during hospitalization,and has no adverse effects on long-term neuropsychological development of infants,which has good clinical value and is worthy of clinical promotion and application.