双水平与传统CPAP治疗新生儿RDS的疗效比较

Clinical efficacy of bi-CPAP and conventional CPAP for neonatal respiratory distress syndrome

目的评价双水平正压通气(bi-CPAP)与传统经鼻持续正压通气(nCPAP)对新生儿呼吸窘迫综合征(RDS)的疗效差异。方法选择2013年1月至2016年12月在深圳市福田区妇幼保健院就诊的RDS患儿20例,分别交叉使用bi-CPAP和nCPAP,每次治疗时间1h,分别使用两次,疗程共4h。测量治疗期间吸入氧浓度分数(FiO2)、经皮CO2分压(tcCO2)、心率、呼吸频率、胸廓运动、血氧浓度和血压,评价窒息、心动过缓、低氧等心肺功能指标。结果两组治疗期间心率、血氧浓度、tcCO2、呼吸频率、FiO2和收缩压组间比较差异均无统计学意义(均P>0.05)。bi-CPAP组舒张压和平均动脉压高于nCPAP组,组间比较差异均有统计学意义(t值分别为4.192、3.971,P值分别为0.026、0.033)。两组窒息、心动过缓、低氧事件发生次数等心肺功能指标组间比较差异均无统计学意义(均P>0.05)。结论 bi-CPAP和nCPAP对RDS患儿的血气指标和心肺功能疗效无明显差异。

Objective To evaluate the clinical efficacy of bi-level continuous positive airway pressure（bi-CPAP）and conventional nasal continuous positive airway pressure（nCPAP）on neonatal respiratory distress syndrome（RDS）.Methods From January 2013 to December 2016,20 neonates with RDS were enrolled in Maternal and Child Health Hospital of Futian District.Bi-CPAP and nCPAP were used alternatively for two times in 1 h,and the course was 4 hours.Inhaled oxygenation fraction（FiO2）,transcutaneous CO2（tcCO2）,heart rate,respiratory rate,thoracic exercise,blood oxygen concentration and blood pressure during treatment course were measured.Cardiopulmonary function such as apnea,bradycardia and hypoxia were evaluated as well.Results There were no significant differences in heart rate,blood pressure,tcCO2,respiratory rate,FiO2 and systolic pressure between two groups（P〈0.05）.The diastolic and mean arterial pressures in bi-CPAP group were significantly higher than those in nCPAP group（t value was 4.192 and 3.971,respectively,P value was 0.026 and 0.033,respectively）.There was no significant difference in cardiopulmonary function such as apnea,bradycardia and hypoxia between two groups（all P〈0.05）.Conclusion There is no significant difference in blood gas and cardiopulmonary function between bi-CPAP and nCPAP for children with RDS.