不同角度注入肺表面活性物质对早产儿支气管肺发育不良和颅内出血的影响：一项前瞻性随机对照研究

Impact of different angles of pulmonary surfactant administration on bronchopulmonaryplasia and intracranial hemorrhage in preterm infants: a prospective randomized controlled study

摘要:

目的 不同角度注入肺表面活性物质对早产儿支气管肺发育不良和颅内出血发生的影响。方法 前瞻性纳入2019年1月—2023年5月就诊于安徽医科大学附属省立医院新生儿科的146例早产儿（胎龄<32周）为研究对象。随机分为不同角度注入肺表面活性物质组，即0°组（34例）、30°组（36例）、45°组（38例）、60°组（38例），分析比较各组临床指标和结局的差异。结果 60°组给药后的氧合指数低于其他3组，使用有创呼吸机时间、用氧时间短于其他3组，支气管肺发育不良发生率低于其他3组（P<0.05）。60°组颅内出血发生率低于0°组（P<0.05）。60°组治愈率高于0°组和30°组（P<0.05）。结论 60°角注入肺表面活性物质的临床疗效高于其他角度，且能降低早产儿颅内出血和支气管肺发育不良的发生率。

Abstract:

Objective To investigate the effects of different angles of pulmonary surfactant (PS) administration on the incidence of bronchopulmonary dysplasia and intracranial hemorrhage in preterm infants.Methods A prospective study was conducted on 146 preterm infants (gestational age <32 weeks) admitted to the Department of Neonatology, Provincial Hospital Affiliated to Anhui Medical University from January 2019 to May 2023. The infants were randomly assigned to different angles for injection of pulmonary surfactant groups: 0° group (34 cases), 30° group (36 cases), 45° group (38 cases), and 60° group (38 cases). Clinical indicators and outcomes were compared among the groups.Results The oxygenation index was lower in the 60° group compared with the other three groups, with shorter invasive ventilation time and oxygen use time, and a lower incidence of bronchopulmonary dysplasia than the other three groups (P<0.05). The incidence of intracranial hemorrhage was lower in the 60° group compared to the 0° group (P<0.05). The cure rate in the 60° group was higher than that in the 0° group and the 30° group (P<0.05).Conclusions The clinical efficacy of injection of pulmonary surfactant at a 60° angle is higher than other angles, reducing the incidence of intracranial hemorrhage and bronchopulmonary dysplasia in preterm infants.