同步经鼻间歇正压通气治疗早产儿频发呼吸暂停

The clinical research of the nasal synchronization intermittent positive pressure ventilation in treating freqent apnea of premature infants

目的探讨同步经鼻间歇正压通气(NSIPPV)及经鼻持续正压通气(NCPAP)治疗早产儿频发呼吸暂停的疗效。方法将2015年1月1日-12月31日西北妇女儿童医院收治的≤34周发生频发呼吸暂停的早产儿40例纳入经鼻同步间歇正压通气(NSIPPV)组,并随机抽取2014年1月1日-12月31该院≤34周发生频发呼吸暂停的早产儿40例纳入经鼻持续正压通气(NCPAP)组,两组患儿胎龄均小于34周,出生时胎龄、出生体重比较差异无统计学意义,两组患儿分别给予综合治疗,观察两组效果。结果 NSIPPV组治疗频发呼吸暂停总有效率更高(P<0.01),两组给予辅助通气后1h和12h,24h,48h的pH、PCO2,PO2指标比较差异均有统计学意义(P均<0.01),两组总辅助通气时间和总氧气暴露时间比较差异有统计学意义(P均<0.01),NIPPV组治疗失败转为气管插管机械通气几率明显少于NCPAP组(P<0.01),气漏发生率较NCPAP低(P均<0.01)。结论 NSIPPV治疗早产儿频发呼吸暂停较NCPAP更有效,血气结果明显改善,并减少气管插管机械通气几率,减少气漏发生,减少总体辅助通气时间。

Objective To investigate the therapeutic effects on premature infant apnea by the two different treatments of the nasal synchronization intermittent positive pressure ventilation （NSIPPV） and nasal continuous positive airway pressure （NCPAP）. Methods NSIPPV group included 40 cases of frequent apnea on premature infants with gestational age≤ 34 weeks treated in Northwest Women and Children Hospital during the period from January 1,2015 to December 31,2015. And NCPAP group included randomly selected 40 cases of frequent apnea on premature infants with gestational age~ 34 weeks treated in Northwest Women and Children Hospital during the period from January 1,2014 to December 31,2014. There were no significant differences in their gestational ages at birth and birth weights. The two groups were given comprehensive treatments and the effects were observed. Results NSIPPV group had higher efficiency （P〈0.01）. The two groups were respectively given assisted ventilation for 1 h, 12 h, 24h, 48h, and there were significant differences in pH, PCO2, PO2 indicator （P〈0.01）. There were significant differences between the two groups in the total ventilation time and total oxygen exposure time （P all〈0.01）. Rate of switched to intubation and the probability of mechanical ventilation of NSIPPV group after treatment failure was significantly less than that of NCPAP group （P〈0.01）. The NSIPPV probability of air leak was lower than NCPAP （P〈0.01）. Conclusion NSIPPV is more effective than NCPAP on preterm infants with frequent apnea,blood gas results were improved significantly. The probabilities of intubation and mechanical ventilation, air leak are reduced. The overall time assisted ventilation are also reduced.