经胃管微创注入肺表面活性物质技术治疗新生儿呼吸窘迫综合征的效果

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Abstract Objective To investigate the effect of minimally invasive injection of pulmonary surfactant through gastric tube in the treatment of neonatal respiratory distress syndrome. Methods Forty preterm infants with respiratory distress syndrome (RDS) diagnosed by neonatal intensive care unit (NICU) in Hubei Maternal and Child Health Hospital from May 2017 to May 2018. According to the random number table method, they were divided into two groups, namely, minimally invasive injection of pulmonary surfactant through gastric tube (LISA group, 20 cases) and tracheal intubation-pulmonary surfactant-extubation (INSURE group, 20 cases). In LISA group, 5F gastric tube was inserted into trachea under direct laryngoscope and pulmonary surfactant (PS) was slowly injected into trachea under nasal continuous positive airway pressure (NCPAP). In INSURE group, PS was injected through tracheal intubation and NCPAP was performed after extubation. The changes of ventilator parameters, adverse reactions incidence of and complications after treatment were observed. Results In LISA group, the decrease of oxygen saturation (SpO2) in 1 case, bradycardia in 1 case, apnea in 0 cases and mechanical ventilation in 72 hours after birth were significantly lower than those in INSURE group SpO2 in 9 cases, bradycardia in 8 cases, apnea in 7 cases; in LISA group, the decrease of oxygen concentration in 6 hours was 19%, higher than that in INSURE group (13%), with significant difference (P ＜ 0.05). There was no significant difference in the incidence of re-use of PS, mortality, air leakage, bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of premature infants, intracranial hemorrhage between the two groups (P ＞ 0.05). Conclusion LISA is a safe and effective method for the treatment of RDS.

Key words： Lung surface active substances Tracheal intubation-pulmonary surfactant-extubation technology Minimally invasive pulmonary surfactant administration Respiratory distress syndrome Neonatal

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	ZHANG Pei XIA Shiwen ZHU Huaping PENG Sicong

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ZHANG Pei XIA Shiwen ZHU Huaping PENG Sicong. Effect of minimally invasive injection of pulmonary surfactant through gastric tube in the treatment of neonatal respiratory distress syndrome[J]. 中国医药导报, 2020, 17(6): 95-98,114.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I6/95

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