摘要
目的比较非Magill钳辅助微侵入性肺表面活性物质(PS)注入(LISA)技术与气管插管-气管内注入PS-拔管后持续呼吸道正压通气(InSurE)技术。方法回顾分析172例胎龄<32周,患新生儿呼吸窘迫综合征(NRDS)并使用PS的早产儿的临床资料。其中LISA组(n=106)通过非Magill钳辅助LISA技术注入PS,InSurE组(n=66)通过InSurE技术注入PS,比较两组的临床特点并分析两种方法对预后的影响。结果与InSurE组相比,LISA组胎龄小,体质量轻,男性、猪肺磷脂使用比例高,差异具有统计学意义(P<0.05)。经倾向性评分匹配(PSM)后,共匹配成功43对病例,两组间基线资料的差异不再具有统计学意义(P>0.05)。PSM后两组间主要结局(病死率及支气管肺发育不良发生率)及次要结局(用氧时间、无创辅助通气时间、机械通气时间、生后72小时内开始的机械通气率、生后72小时后开始的机械通气率、总机械通气率等)差异均无统计学意义(P>0.05)。结论与InSurE技术相比,非Magill钳辅助LISA技术安全可行,但是否可减少支气管肺发育不良发生率及病死率,仍有待进一步论证。
Objective To compare the non-Magill forceps-assisted less invasive pulmonary surfactant(PS)administration(LISA)technique and the intubation surfactant and extubation(InSurE)technique.Methods The clinical data of 172 preterm infants(<32 weeks of gestational age)with neonatal respiratory distress syndrome(NRDS)treated with PS were retrospectively analyzed.In the LISA group(n=106),PS was injected with non-Magill forceps-assisted LISA technique,while in the InSurE group(n=66),PS was injected with InSurE technique.The clinical characteristics of the two groups were compared and the effects of the two methods on prognosis were analyzed.Results In the LISA group,gestational age was smaller,body weight was lower,proportion of male and usage of poractant alfa were more than those in the InSurE group.The differences were statistically significant(P<0.05).After the propensity score matching(PSM),a total of 43 pairs of cases were successfully matched,there was no significant difference between the two groups in baseline data(P>0.05).There were no significant differences between the two groups after PSM in the main outcomes(mortality and incidence of bronchopulmonary dysplasia)and secondary outcomes(oxygen consumption time,noninvasive ventilation time,mechanical ventilation time,mechanical ventilation rate within 72 hours after birth,mechanical ventilation rate 72 hours after birth and total mechanical ventilation rate,etc.)(all P>0.05).Conclusions Compared with InSurE technology,non-Magill forceps-assisted LISA technique is safe and feasible,but whether it can reduce the incidence of BPD and mortality remains to be further investigated.
作者
刘晓
陈平洋
谭鑫
董青艺
LIU Xiao;CHEN Pingyang;TAN Xin;Dong Qingyi(Department of Neonatology,Second Xiangya Hospital,Central South University,Changsha 410011,Hunan,China;Department of Pediatrics,First Hospital of Changsha,Changsha 410005,Hunan,China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2021年第6期415-420,共6页
Journal of Clinical Pediatrics
基金
湖南省科技厅重点项目(No.2020SK3045)
长沙市科技局一般项目(No.kq 2001008)。
