经鼻双水平和持续气道正压通气治疗早产儿呼吸暂停的疗效比较

Comparison of the effect of nasal Duo positive airway pressure ventilation and continous positive airway pressure on apnea of prematurity

目的：对比经鼻双水平气道正压通气（nDuoPAP）与持续气道正压通气（NCPAP）治疗早产儿呼吸暂停（AOP）的疗效。方法：选取2012年1月～2014年1月在郑州市儿童医院诊断为原发性AOP的38例早产儿，在给予常规护理及药物治疗的基础上，随机给予nDuoPAP（研究组）或NCPAP（对照组）呼吸支持，每组19例；若两种通气方式无效时，则立即给予气管插管呼吸机辅助通气，作为抢救性治疗。结果：研究组显效、总有效率明显高于对照组（P〈0．05）；两组患儿因治疗无效或病情加重而行气管插管呼吸机辅助通气率，研究组明显低于对照组（P=0．029）；两组患儿并发气漏、鼻压伤、颅内出血、腹胀的发生率比较；差异无统计学意义（P〉0．05）。结论：nDuoPAP通气模式治疗AOP比NCPAP模式更有效，而且安全。

Objective： To compare the effect of nasal Duo positive airway pressure ventilation （nDuoPAP） and eontinous positive airway pressure （NCPAP） in treating apnea of prematurity. Methods： 38 preterm neonates diagnosed with primary apnea admitted to NICU of the Zhengzhou Children＇s Hospital from January 2012 to January 2014 were selected in this study and randomly given nDuoPAP （ treatment group） or NCPAP （control group） on the basis of routine care and drug therapy, 19 cases in each group. If the two noninvasive ventilations were not effective, endotracheal iutubation and mechanical ventilation were used as rescue therapy. Results： The particular effective rate and total effective rate of the nDuoPAP group were obviously higher than those of the NCPAP group, there were significant differences （63.2% vs26. 3%, 89. 5% vs52. 6%, P〈0. 05）. The incidence of endotracheal intubation and mechanical ventilation was significantly lower in the nDuoPAP group than that of the NCPAP group （ 10. 5% vs47.4%, P=0. 029） . There were no significant differences in pneumothorax, na- sal skin damage, IVH, abdominal distension between two groups （ P〉0. 05 ） . Conclusion ： nDuoPAP is more effective in treating apnea of prematurity than NCPAP and safe.