经胃管微创注入肺表面活性物质技术联合经鼻持续气道正压通气治疗新生儿呼吸窘迫综合征的效果

目的:观察经胃管微创注入肺表面活性物质(LISA)技术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(RDSN)的临床效果。方法:选取86例RDSN患儿作为研究对象,根据随机数字表法分为对照组(41例)和研究组(45例)。对照组予气管插管-肺表面活性物质-拔管后经鼻持续气道正压通气(INSURE)治疗,研究组予LISA技术联合NCPAP治疗,比较两组患儿临床疗效,治疗前后血气指标水平及并发症发生率。结果:治疗后,研究组患儿治疗总有效率为93.33%,高于对照组的78.05%,差异有统计学意义(P<0.05);两组PO2水平均高于治疗前,且研究组高于对照组,PCO2和FiO2水平均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05);研究组患儿并发症发生率为8.89%,低于对照组的26.83%,差异有统计学意义(P<0.05)。结论:LISA技术联合NCPAP治疗RDSN效果较好,可改善患儿血气和呼吸指标。

Effects of less invasive pulmonary surfactant administration via gastric tube combined with nasal continuous positive airway pressure on neonatal respiratory distress syndrome

Objective:To study clinical effects of less invasive pulmonary surfactant administration(LISA)via gastric tube combined with nasal continuous positive airway pressure(NCPAP)on neonatal respiratory distress syndrome(RDSN).Methods:86 children with RDSN were selected as the research objects,and were divided into control group(41 cases)and study group(45 cases)according to the random number table method.The control group was treated with Intubate-Surfactant-Extubate to CPAP(INSURE),while the study group was treated with LISA combined with NCPAP.The clinical efficacy,blood gas levels and complications were compared between the two groups.Results:After the treatment,the total effective rate of the study group was 93.33%,which was higher than 78.05%in the control group,and the difference was statistically significant(P<0.05).The levels of PO2 in the two groups were higher than before the treatment,and that of the study group was higher than that of the control group;the levels of PCO2 and FiO2 were lower than before the treatment,and those of the study group were lower than those of the control group;and the differences were statistically significant(P<0.05).The incidence of complications in the study group was 8.89%,which was lower than 26.83%in the control group,and the difference was statistically significant(P<0.05).Conclusions:LISA combined with NCPAP is effective in the treatment of RDSN,and can significantly improve the blood gas and respiratory indexes.