双水平气道正压通气序贯治疗早产儿呼吸窘迫综合征效果分析

Effects of bi-level positive airway pressure sequential therapy on premature infants with respiratory distress syndrome

目的:探讨双水平气道正压通气(BiPAP)序贯治疗早产儿呼吸窘迫综合征(RDS)效果及对血气指标、血清炎症因子的影响。方法:选取2016年3月~2017年3月我院收治的142例RDS早产儿为对象,采用随机数字表法将其均分为研究组和对照组各71例,对照组实施经鼻腔持续气道正压通气(CPAP),研究组实施BiPAP序贯,比较两组临床疗效和治疗前后的血气指标、血清炎症因子水平。结果:治疗前两组的血气指标[血氧分压(PO_2)、二氧化碳分压(PCO_2)、血氧饱和度(SaO_2)]和血清炎症因子[白细胞介素-10(IL-10)、肿瘤坏死因子(TNF-α)]水平相比较差异无统计学意义(P>0.05),通气12 h后研究组临床总有效率高于对照组,研究组的PO_2、SaO_2、IL-10水平高于对照组,PCO_2、TNF-α水平低于对照组,研究组的治疗时间和通气时间短于对照组,差异均有统计学意义(P<0.05)。结论:BiPAP序贯治疗RDS早产儿效果好,见效快,可明显改善血气指标、血清炎症因子水平,值得进一步推广使用。

Objective： To explore the efficacy of bi-level positive airway pressure（ BiPAP） sequential therapy on premature infants with respiratory distress syndrome（ RDS） and its effects on blood gas indexes and serum inflammatory factors. Methods： 142 cases of premature infants with RDS who were admitted to the hospital from March 2016 to March2017 were selected for the study. They were evenly divided into study group and control group,with 71 cases in each group according to the random number table method. Control group was given trans-nasal continuous positive airway pressure（ CPAP）,and study group was given BiPAP sequential therapy. The clinical efficacy,blood gas indexes and serum inflammatory factors before and after treatment were compared between the two groups. Results： There was no significant difference in levels of blood gas indexes [partial pressure of oxygen（ PO2）,partial pressure of carbon dioxide（ PCO2）,oxygen saturation（ SaO2） ]and serum inflammatory factors [interleukin-10（ IL-10）,tumor necrosis factor α（ TNF-α） ]between the two groups before treatment（ P〈0. 05）,and the total clinical effective rate of study group after 12 h of ventilation was higher than that in control group,and the levels of PO2,SaO2 and IL-10 in study group were higher than those in control group; while the levels of PCO2 and TNF-α were lower than those in control group,and the treatment time and ventilation time in study group were shorter than those in control group（ P〈0. 05）. Conclusions： Bi PAP sequential therapy has good effects and quick returns in the treatment of premature infants with RDS,and it can significantly improve levels of blood gas indexes and serum inflammatory factors. Therefore,it is worthy of further promotion and application.