无创呼吸机联合咖啡因治疗极低出生体重早产儿呼吸窘迫综合征的临床研究

Clinical Research of Non-invasive Ventilator Combined with Caffeine in the Treatment of Respiratory Distress Syndrome in Very Low Birth Weight Premature Infants

目的:观察无创呼吸机联合咖啡因治疗极低出生体重早产儿呼吸窘迫综合征的临床效果,分析无创呼吸机联合咖啡因的临床应用价值。方法:选取2014年1月-2016年1月在本院诊断治疗的极低出生体重早产儿呼吸窘迫综合征患儿85例作为研究对象,根据其治疗方法分为试验组和对照组,对照组给予无创呼吸机通气联合氨茶碱进行治疗,试验组给予无创呼吸机联合咖啡因进行治疗,观察并对比两组患儿的临床疗效、治疗前后的PO_2和PCO_2血气分析指标、呼吸暂停次数及呼吸机通气时间等。结果:治疗后,试验组的临床总有效率为95.6%,高于对照组的85.0%,差异有统计学意义(P<0.05)。两组治疗前的PO_2和PCO_2血气分析指标比较,差异均无统计学意义(P>0.05),两组治疗后的PO_2和PCO_2血气分析指标均优于治疗前,差异均有统计学意义(P<0.05),试验治疗后的PO_2和PCO_2血气分析指标均优于对照组,差异均有统计学意义(P<0.05)。试验组呼吸暂停次数为(1.02±0.21)次,少于对照组的(1.98±0.26)次,差异有统计学意义(P<0.05)。试验组呼吸机通气时间为(3.92±2.13)d,短于对照组的(5.29±2.45)d,差异有统计学意义(P<0.05)。试验组发生慢性肺疾病2例,动脉导管未闭1例,总发生率为6.7%;对照组发生慢性肺疾病5例,动脉导管未闭2例,总发生率为17.5%,两组比较差异有统计学意义(P<0.05)。结论:无创呼吸机联合咖啡因治疗极低出生体重早产儿呼吸窘迫综合征的疗效显著,具有一定的应用价值。

Objective：To observe the clinical efficacy of non-invasive ventilator combined with caffeine in the treatment of respiratory distress syndrome in very low birth weight premature infants.Method：85 low birth weight premature infants with respiratory distress syndrome in our hospital from January 2014 to January 2016 were selected as study subjects,according to the treatment methods,they were divided into experimental group and control group,the control group received non-invasive ventilation in preterm infants and aminophylline treatment,the experimental group was treated with non-invasive ventilator combined with caffeine,the clinical efficacy,PO_2 and PCO_2 blood gas analysis before and after treatment,the number of apnea and breathing machine ventilation time of the two gropus were observed and compared.Result：After treatment,the total effective rate of the experimental group was 95.6%,which was higher than 85.0% of the control group,the difference was statistically significant（P〈0.05）.Before treatment,the PO_2 and PCO_2 blood gas analysis index of two groups were compared,there were no significant differences（P〈0.05）,after treatment,the PO_2 and PCO_2 blood gas analysis index of the two groups were better than those before treatment,the differences were statistically significant（P〈0.05）,and after treatment PO_2 and PCO_2 blood gas analysis index in experimental group were better than those in control group,the differences were statistically significant（P〈0.05）.The number of apnea in the experimental group was（1.02±0.21） times,less than（1.98±0.26）times of the control group,the difference was statistically significant（P〈0.05）.The time of breathing machine ventilation in experimental group was（3.92±2.13）d,shorter than（5.29±2.45）d of the control group,the difference was statistically significant（P〈0.05）.The experimental group had chronic pulmonary disease in 2 cases,1 case of patent ductus arteriosus,the total incidence rate was 6.7%;the control group occurred in 5 patients with chronic lung disease,patent ductus arteriosus in 2 cases,the total incidence rate was 17.5%,there was significant difference between two groups（P〈0.05）.Conclusion：Non-invasive mechanical ventilation combined with caffeine in the treatment of very low birth weight premature infants with respiratory distress syndrome has significant effect,and has certain application value.