同步鼻塞间歇正压通气治疗新生儿呼吸衰竭的有效性分析

Analysis of the effectiveness of synchronized nasal intermittent positive pressure ventilation for neonatal respiratory failure

目的探讨同步鼻塞间歇正压通气（synchronized nasal intermittent positive pressure ventilation，SNIPPV）模式对新生儿呼吸衰竭的临床治疗有效性。方法回顾性分析2016年1月至2018年1月于本院接受治疗的52例新生儿呼吸衰竭患儿，依据治疗方法不同分为研究组和对照组各26例，研究组患儿采用SNIPPV模式通气治疗，对照组患儿使用同步间歇正压通气（synchronized intermittent positive pressure ventilation，SIPPV）模式通气治疗，观察两组患儿的治疗前和治疗后血气离子分析结果的变化情况、用氧时间及住院时间，对两组患儿的临床效果及并发症进行对比分析。结果两组患儿治疗后24 h呼吸频率和心率均有改善，两组间比较差异无统计学意义（P均〉0.05）；研究组患儿治疗总有效率为88.5%，对照组为92.3%，两组间比较差异无统计学意义（χ^2＝0.221，P〉0.05）；两组患儿治疗后24 h的pH值、PaO2、PaCO2及血氧饱和度水平较治疗前均改善（P均〈0.05 ），但两组间比较差异均无统计学意义（P均〉0.05）；与对照组患儿相比，研究组患儿的用氧时间及住院时间明显缩短，差异均有统计学意义（P均〈0.05 ）；并且研究组患儿呼吸机相关性肺炎并发症更少。结论应用SNIPPV模式辅助通气治疗新生儿呼吸衰竭，效果显著，可缩短用氧时间及住院时间，减少并发症，值得推广SNIPPV模式辅助通气。

ObjectiveTo investigate the clinical effect of synchronized nasal intermittent positive pressure ventilation （SNIPPV） in the treatment of neonatal respiratory failure.MethodsThe clinical data of 52 neonates with respiratory failure treated in our hospital from January 2016 to January 2018 were retrospectively analyzed.According to the different treatment methods, they were divided into observation group and control group, 26 cases in each group.The children in the observation group were treated with SNIPPV, while those in the control group were treated with synchronized intermittent positive pressure ventilation （SIPPV）. Clinical efficacy, changes of blood gas analysis results before and after treatment, oxygen consumption time and hospital stay, and complications were compared between the two groups.ResultsThe respiratory rate and heart rate of the two groups improved after treatment, but there were no significant differences between the two groups（P〉0.05, respectively）. The total effective rate of the observation group was 88.5%, while that of the control group was 92.3%, there was no significant difference between the two groups（χ^2=0.221, P〉0.05）. The pH, PaO2, PaCO2 and oxygen saturation levels of 24 h after treatment in two groups were improved （P〈0.05, respectively）, but there were no significant differences between the two groups （P〉0.05, respectively）. Compared with the control group, the oxygen consumption time and hospitalization time of the observation group were significantly shorter, and the differences were statistically significant （P〈0.05, respectively）. And the observation group had fewer complications of ventilator associated pneumonia.ConclusionThe effect of SNIPPV in the treatment of neonatal respiratory failure is significant.It could shorten the time of oxygen consumption and hospitalization and reduce the complications.It is worth popularizing SNIPPV mode assisted ventilation.