Comparative Study On The Efficacy Of LISA And INSURE In The Treatment Of NRDS

Objecttive:To evaluate the efficacy of LISA technique in the treatment of NRDS by comparing with INSURE technique.Methods:According to the inclusion and exclusion criteria,72 premature infants diagnosed with NRDS and gestational age between 28 and 34 weeks during November 2016 to December 2018 in the neonatology,Yan’an University Affiliate Hospital were screened and collected.They were randomly divided into LISA technique group(experimental group)and INSURE technology group(control group)by random number table method.In the course of treatment,5 cases of the experimental study were withdrawn due to family economy and other reasons.A total of 67 children with NRDS were collected.There were 33 patients in the experimental group,16 males and 17 females;34 patients in the control group,21 males and 13 females.Blood samples were first collected for blood gas analysis before randomization.After routine treatment with warming,oxygen therapy,infection prevention,and maintaining internal environment stability in both groups,for the experimental group,the laryngoscope was used to visually in the throat.the improved gastric tube(8F)was placed in the trachea with Magill bending forceps,the laryngoscope was removed,and the child underwent spontaneous breathing,and the PS was instilled into the trachea through the improved gastric tube,and the whole process was performed with NCPAP uninterrupted assisted ventilation(LISA technique).The control group was given an endotracheal intubation,and the PS was slowly instilled into the airway through the tracheal tube,and the tracheal tube was removed for non-invasive NCPAP-assisted breathing(INSURE technique).The blood gas analysis in the two groups before and after technical operation,the decrease of SpO2 during the injection,the occurrence of bradycardia,the occurrence of mechanical ventilation within 3 days and the near and long-term concurrent treatment of PDA,PPHNand BPD under different technical operations were compared.Prognostic aspects such as ventilation time and hospital stay were also compared.Results:1.There was no significant difference in the general data of gestational age,birth weight,admission age,Apgar score,gender,mode of delivery,NRDS classification between the observation group and the control group(p>0.05).2.There was no significant difference in the improvement of PaO2 and PaCO2 in children with LISA technique.3.In the course of technical operation,the incidence of SpO2 and bradycardia in the two groups were significantly lower in the experimental group than in the control group(P<0.05).4.There was no significant difference in the incidence of mechanical ventilation between the two groups(P>0.05).5.In the experimental group,the incidence of long-term complications of BPD,P=0.045(P<0.05),the difference was statistically significant.There was no significant difference in early complications such as PDA,PPHN,pulmonary hemorrhage,and NEC(P>0.05).6.There was no significant difference between the two techniques in reducing the duration of continuous assisted ventilation and shortening the hospitalization(P>0.05).Conclusions:1.LISA technology can reduce the incidence of long-term complications of BPD,while LISA technology does not increase the incidence of other recent complications such as PDA,PPHN,pulmonary hemorrhage,NEC.2.LISA technology can significantly reduce the incidence of SpO2 and bradycardia in children during PS administration.3.LISA technology has no significant advantage in improving children’s blood gas PaO2,PaCO2,reducing mechanical ventilation within 3 days,reducing the duration of continuous assisted ventilation and shortening the length of hospital stay.