微创肺表面活性物质给药技术在早产儿呼吸窘迫综合征36例中的应用

目的 探讨微创肺表面活性物质给药（LISA）技术在早产儿呼吸窘迫综合征（RDS）中的应用疗效及对早产儿住院期间并发症的研究。方法 回顾性分析2020年1月至2022年2月安徽省妇幼保健院收治并确诊为RDS、胎龄在25～32周的RDS早产儿82例的临床资料，根据治疗方法不同分为A组（LISA技术，36例）和B组[气管插管-肺表面活性物质-拔管（INSURE）技术，46例]。A组采用LISA技术完成肺表面活性物质（PS）给药方法，B组采用INSURE技术完成PS给药。结果 用氧总时间A组（30.67±15.03）h,B组（39.06±18.17）h；住院总时间A组（41.67±15.78）h,B组（49.60±17.09）h；辅助通气总时间A组（21.76±10.16）h,B组（28.89±13.22）h，组间均差异有统计学意义（P<0.05）。A组病儿2次PS发生率、PS反流发生率和72 h机械通气治疗率分别为0.00%(0/36)、2.78%(1/36)和5.56%(2/36)，显著低于B组的15.22%(7/46)、17.39%(8/46)和21.74%(10/46)。A组病儿...

Application of less invasive surfactant administration in 36 premature infants with respiratory distress syndrome

Objective To explore the efficacy of less invasive surfactant administration (LISA) in the treatment of respiratory dis?tress syndrome (RDS) and complications during hospitalization of preterm neonates.Methods A retrospective analysis was made of the clinical data of 82 preterm infants with gestation age of 25~32 weeks and diagnosed with RDS who were admitted to Anhui Provin?cial Maternity and Child Health Hospital from January 2020 to February 2022. They were randomly assigned to group A in which the administration of pulmonary surfactant (PS) was via less invasive surfactant administration (LISA, 36 cases) and group B in which the PS administration was via intubation-surfactant-extubation (INSURE, 46 cases).Results The total time of oxygen use was (30.67±15.03) h in group A and (39.06±18.17) h in group B. The total length of hospital stay of group A was (41.67±15.78) h, and that of group B was (49.60±17.09) h. The total time of auxiliary ventilation in group A and group B was (21.76±10.16) h and (28.89±13.22) h, respec?tively. The differences between groups were statistically significant (P < 0.05). The incidences of second-time PS, PS regurgitation and 72-hour mechanical ventilation in group A were 0.00% (0/36), 2.78% (1/36) and 5.56% (2/36), respectively, significantly lower than 15.22% (7/46), 17.39% (8/46) and 21.74% (10/46) in group B. The incidences of pneumothorax, hemodynamically significant patent ductus arteriosus (hsPDA) and bronchopulmonary dysplasia (BPD) in group A were 2.78% (1/36), 27.78% (10/36) and 27.78% (10/36),respectively, significantly lower than 19.57% (9/46), 50.00% (23/46) and 52.17% (24/46) in group B.Conclusion The treatment of preterm neonates with RDS via LISA can effectively relieve the respiratory status of infants, ensure the accuracy of PS medication dose,shorten the length of hospital stay, and reduce complications, which is worthy of clinical application.