LISA技术与INSURE技术分别联合NCPAP治疗新生儿呼吸窘迫综合征的效果比较

Comparison of Efficacy between LISA Technique and INSURE Technique Combined with NCPAP in Treatment of Neonatal Respiratory Distress Syndrome

目的:比较经胃管微创注入肺表面活性物质(LISA)技术与经气管插管注入肺表面活性物质(INSURE)技术分别联合经鼻持续气道正压通气(NCPAP)治疗新生儿呼吸窘迫综合征(RDS)的效果。方法:选取2016年1月-2018年1月本院收治的RDS患儿74例。按照随机数字表法将其分为A、B组,各37例。A组予以患儿LISA联合NCPAP治疗,B组给予患儿INSURE联合NCPAP治疗。比较两组患儿的并发症、死亡率、心动过缓、脉搏血氧饱和度(SpO_2)下降、再次使用PS率以及72 h机械通气率等指标情况。结果:A组患儿注入PS均成功,B组出现1例患儿需要二次置管;A组心动过缓、脉搏SpO_2下降、72 h机械通气率均低于B组,比较差异均有统计学意义(P<0.05);两组再次使用PS率、死亡率、早产儿视网膜病变、气胸、颅内出血、坏死性小肠结肠炎发生率比较,差异均无统计学意义(P>0.05);A组支气管肺发育不良发生率低于B组,比较差异有统计学意义(P<0.05)。结论:与INSURE技术比较,LISA技术治疗RDS效果更加明显,可以作为安全有效的给药途径在临床推广使用。

Objective:To compare the efficacy of transnasal continuous positive airway pressure ventilation(NCPAP)in treatment of neonatal respiratory distress syndrome(RDS)by minimally invasive injection of pulmonary surfactant(LISA)via gastric tube and by infusion of pulmonary surfactant(INSURE)via tracheal intubation.Method:A total of 74 RDS children admitted to our hospital from January 2016 to January 2018 were selected.According to the random number table method,they were divided into A group and B group,37 cases in each group.A group was treated with LISA and NCPAP,while B group was treated with INSURE and NCPAP.The complications,mortality,bradycardia,decreased SpO2,re-use of PS and 72-hour mechanical ventilation between two groups were compared.Result:The PS was injected successfully in A group,and 1 patient needed two catheterization in B group,the bradycardia,decreased SpO2 and 72 h mechanical ventilation rate in A group were lower than those of B group,the differences were statistically significant(P<0.05).The rates of re-use of PS,mortality,retinopathy of premature infants,pneumothorax,intracranial hemorrhage and necrotizing enterocolitis in two groups were compared,the differences were not statistically significant(P>0.05).The incidence of bronchopulmonary dysplasia in A group was lower than that of B group(P<0.05).Conclusion:Compared with the INSURE technology,LISA technology is more effective in treatment of RDS,which can be used as a safe and effective way of drug administration in clinical promotion.