经鼻间歇正压通气和持续气道正压通气在早期早产儿呼吸窘迫综合征中应用的比较

目的对新生儿呼吸窘迫综合征(RDS)的早产儿早期使用经鼻间歇正压通气(NIPPV)和经鼻持续气道正压通气(NCPAP)模式在有创呼吸支持率、疗效及并发症方面进行比较分析。方法随机对照试验,将胎龄28~34周患有RDS的新生儿分为早期使用NIPPV组和早期使用NCPAP组。观察患儿生后72h内的插管有创呼吸支持率、支气管肺发育不良(BPD)发生率及使用无创呼吸支持后1、12、24h二氧化碳分压(PaCO2)、氧分压(PaO2)及氧合指数(OI)。结果①NIPPV组生后72h内有创呼吸支持明显低于NCPAP组;NIPPV组OI在无创呼吸支持后1、12、24h均高于NCPAP组;NIPPV组无创呼吸支持后1、12、24hPaCO2明显低于NCPAP组;NIPPV组PaO2在无创呼吸支持后1、12、24h明显高于NCPAP组;(P<0.05)。②两组患儿氧疗总时间NIPPV组低于NCPAP组,(P<0.05)。结论早期使用NIPPV与NCPAP相比,可明显降低RDS患儿气管插管有创呼吸支持率,增加潮气量及通气量,改善氧合,值得临床推广。

Nasal Intermittent Positive Pressure Ventilation with Continuous Positive Airway Pressure in Early Preterm Infants with Respiratory Distress Syndrome Application

Objective To neonatal respiratory distress syndrome（RDS） of premature infants early use of nasal intermittent positive pressure ventilation（NIPPV） and nasal continuous positive airway pressure（NCPAP） model with a respiratory support,curative effect and complications of comparative analysis.Method randomized controlled trial,gestational age 28-34 weeks,babies born with RDS within 6h after divided into the early use of NIPPV group and early use of NCPAP.Observing children born within 72h after intubation and respiratory support,incidence of bronchial pulmonary dysplasia（BPD） and the use of noninvasive respiratory support 1,12,24h after carbon dioxide partial pressure（PaCO2）,oxygen partial pressure（PaO2） and oxygenation index（OI）.Result ①NIPPV group within 72h after birth of invasive respiratory support was significantly lower than that in NCPAP group;NIPPV group OI in noninvasive respiratory support after 1,12,24h were higher than that in group NCPAP;group NIPPV noninvasive respiratory support after 1,12,24hPaCO2 were significantly lower than those in group NCPAP;group NIPPV PaO2 in noninvasive respiratory support 1,12,24h were significantly higher than that of NCPAP group（P0.05）.②two groups of children with oxygen therapy time of NIPPV group was lower than that of NCPAP group（P0.05）.Conclusion Early use of NIPPV compared with NCPAP,can obviously reduce the RDS with endotracheal intubation and respiratory support,increase in tidal volume and the ventilation,improve oxygenation,worth clinical promotion.