双水平正压通气与鼻塞持续正压通气治疗早产儿呼吸窘迫综合征临床疗效比较

Clinical Effects Comparison of Duo Positive Airway Pressure and Nasal Continuous Airway Pressure in the Treatment of Neonatal Respiratory Distress Syndrome

目的:观察双水平正压通气(Duo PAP)及鼻塞持续正压通气(n CPAP)在新生儿呼吸窘迫综合征(NRDS)早产儿治疗中的临床疗效与安全性,以期为NRDS的临床治疗提供指导。方法:选取2015年1月至2016年1月我院收治的NRDS早产儿68例,随机分为对照组和观察组各34例。两组患儿均给予猪肺磷脂注射液治疗,对照组在此基础上给予n CPAP治疗,而观察组给予Dou PAP治疗,观察并记录两组患儿治疗前及治疗1、12、24 h后的动脉血气指标、氧合指数(OI),同时比较两组患儿临床疗效、治疗期间的通气、氧疗及住院时间,以及并发症发生情况。结果:对照组治疗12、24 h后的p H、氧分压(Pa O2)、二氧化碳分压(Pa CO2)及OI较治疗前均显著改善,而观察组治疗1、12、24 h后的上述各指标较治疗前也显著改善,差异均有统计学意义(P<0.05);且观察组治疗24 h后的p H,治疗12、24 h后的Pa O2、Pa CO2及OI改善程度均优于对照组,差异有统计学意义(P<0.05);同时观察组治疗有效率(91.18%)略高于对照组(85.29%),但差异无统计学意义(P>0.05),其通气、氧疗及住院时间均短于对照组,差异有统计学意义(P<0.05);观察组的并发症发生率(14.71%)低于对照组(26.47%),差异有统计学意义(P<0.05)。结论:Duo PAP在改善患儿动脉血气指标、临床症状方面的效果优于n CPAP,且治疗有效率及安全性更高,在NRDS的临床治疗上具有重要价值。

Objective： TO observe the clinical effects and safety of duo positive airway pressure （DouPAP） and nasal continuous airway pressure （nCPAP） in the treatment of neonatal respiratory distress syndrome （ NRDS）, so as to provide guidance for the clinical treatment of NRDS. Methods： Sixty-eight cases of NRDS children in our hospital from January 2015 to January 2016 were selected and were randomly divided into the control group （n=34） and observation group （n=34）. Both the two groups were given poractant alfa injection therapy, and the control group was given nCPAP treatment, the observation gouo was eiven DouPAP treatment on that basis.The arterial blood gas index, oxygenation index （OI） before and 1 hour, 12 hours, 24 hours after the treatment were observed and recorded. The clinical effects, duration of ventilation, oxygen therapy, hospital stay, and the incidence of complications were also compared. Results ： The pH, partial pressure of oxygen （ PaOz ） , partial pressure of carbon dioxide （ PaOz ） and OI of 12 hours and 24 hours after the treatment in the control group were significantly improved eompared with before the treatment, and those indexes in the observation group of 1 hour, 12 hours and 24 hours were improved, with significant differences （P〈0.05）, and the improvement of PaOz , PaCOz and OI of 12 hours and 24 hours after the treatment in the observation group were significantly better than in the control group, with signifieant differences （P〈0.05）. The treatment effective rate in the observation group （91. 18% ） was higher than the control group （85.29%）, without significant difference （P〉0.05）, and the ventilation, oxygen therapy and hospital stay were also shorter than those in the control group, with significant differences （P〈0.05）. The complications incidence in the observation group （14.71%） was significantly lower than that in the control group （26.47%）, with significant differenee （P〈0.05）. Conclusion： Compared to the nCPAP, DouPAP can better improve the arterial blood gas index and the clinical symptoms of the effect. The treatment effects and safety are higher with important value.