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经鼻间歇正压通气与经鼻持续气道正压通气治疗早产儿呼吸窘迫综合征的随机对照研究
彭周杰,易明,段娓
0
(重庆市三峡中心医院,重庆 404000)
摘要:
目的:比较经鼻间歇正压通气(NIPPV)与经鼻持续气道正压通气(nCPAP)对早产儿呼吸窘迫综合征(RDS)的疗效。方法:选择2013年4月至2015年3月在我院新生儿重症监护病房住院的RDS早产儿作为研究对象,按随机数字表法将研究对象随机分为NIPPV组(51例)和nCPAP组(57例),所有患儿均常规使用注射用牛肺表面活性剂(珂立苏,华润双鹤药业股份有限公司)70 mg/kg,比较两组患儿动脉血气分析结果、治疗成功率、使用NIPPV和nCPAP时间、主要并发症及其预后结局。结果:两组患儿在性别、胎龄、出生体质量、5 min Apgar评分、RDS分级、产前是否使用激素及生后使用PS 情况等方面比较差异无统计学意义(P均>0.05)。NIPPV组治疗成功45例,治疗成功率88.24%,nCPAP组治疗成功41例,治疗成功率71.93% (P<0.05)。NIPPV组治疗后2 h、12 h 的pH、PaCO2、PaO2比nCPAP组改善更明显(P<0.05)。NIPPV组与nCPAP组治疗时患儿平均使用NIPPV和nCPAP的时间比较差异无统计学意义(P>0.05)。NIPPV组呼吸暂停发生率明显低于nCPAP组,差异有统计学意义(P<0.05)。结论:NIPPV治疗早产儿RDS效果优于nCPAP。
关键词:  经鼻间歇正压通气  经鼻持续气道正压通气  呼吸窘迫综合征  早产儿
DOI:doi:10.13407/j.cnki.jpp.1672-108X.2016.10.004
基金项目:
Nasal Intermittent Positive Pressure Ventilation and Nasal Continuous Positive Airway Pressure in the Treatment of Respiratory Distress Syndrome in Preterm: a Randomized Controlled Study
Peng Zhoujie, Yi Ming, Duan Wei
(Chongqing Three Gorges Central Hospital, Chongqing 404000, China)
Abstract:
Objective: Compare the efficacy of nasal intermittent positive pressure ventilation (NIPPV) with nasal continuous positive airway pressure (nCPAP) in premature infants during the treatment of respiratory distress syndrome (RDS). Methods: Premature infants who underwent RDS were selected in the department of neonatal intensive care unit (NICU) using RCT method. Each patient was treated with pulmonary surfactant (70 mg/kg). The study subjects were randomly divided into NIPPV group and nCPAP group, compared the two groups of patients with arterial blood gas analysis, treatment success rate, NIPPV and nCPAP time, complications and prognosis. Results: There were no significant differences in gender, age, birth weight, 5 minute Apgar score, RDS grade, the prenatal use of hormones and the use of pulmonary surfactant after birth (P >0.05). In NIPPV group (51 cases), 45 cases were treated successfully, the success rate of treatment was 88.24%. nCPAP group (57 cases) was treated successfully in 41 cases, the success rate of treatment was 71.93%, the difference was statistically significant between two groups (P<0.05). NIPPV, PaCO2, PaO2, pH were significantly improved in 2 hours and 12 hours after treatment, and the differences were statistically significant in the two groups (P<0.05). There was no significant difference between NIPPV and NIPPV in the time of therapy (P>0.05). The incidence of apnea in NIPPV group was significantly lower than that in nCPAP group, the difference was statistically significant (P<0.05). Conclusion: NIPPV in treatment of premature infants with respiratory distress syndrome is better than nCPAP.
Key words:  nasal intermittent positive pressure ventilation  nasal continuous positive airway pressure  respiratory distress syndrome  premature infant

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