经鼻间歇正压通气与经鼻持续气道正压通气治疗新生儿呼吸窘迫综合征的临床疗效比较

Comparison of clinical curative effect of nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in the treatment of neonatal respiratory distress syndrome

目的分析经鼻间歇正压通气(NIPPV)与经鼻持续气道正压通气(NCPAP)治疗新生儿呼吸窘迫综合征(NRDS)的疗效。方法 71例NRDS患儿作为研究对象,随机分为间歇组(采用NIPPV, 36例)与持续组(采用NCPAP, 35例)。比较两组治疗3 d后血气变化、呼吸机使用时间、氧疗时间、开奶时间及并发症情况。结果治疗前,两组动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、吸入氧浓度(FiO2)比较差异无统计学意义(P>0.05);治疗3 d后,两组PaO2、PaCO2、FiO2均明显改善,且间歇组改善情况明显优于持续组,差异具有统计学意义(P<0.05)。间歇组呼吸机使用时间(76.24±5.91)h、氧疗时间(86.19±5.01)h明显短于持续组的(98.33±9.73)、(106.84±10.48)h,差异具有统计学意义(P<0.05)。间歇组开奶时间(47.18±6.10)h明显早于持续组的(54.37±5.08)h,差异具有统计学意义(P<0.05)。间歇组并发症发生率13.89%(5/36)明显低于持续组的34.29%(12/35),差异具有统计学意义(P<0.05)。结论 NIPPV能有效缩短NRDS患儿治疗时间,且治疗效果显著,能有效减少治疗中患儿出现CO2潴留、腹胀等并发症出现,改善预后,可临床推广。

Objective To analyze the therapeutic effect of nasal intermittent positive pressure ventilation（NIPPV） and nasal continuous positive airway pressure（NCPAP） in the treatment of neonatal respiratory distress syndrome（NRDS）. Methods A total of 71 children with NRDS were selected as research objects and they were randomly divided into intermittent group for 36 cases and continuous group for 35 cases. The intermittent group received NIPPV, and the continuous group received NCPAP. The changes of blood gas, the mechanical ventilation time, the time of oxygen therapy, breastfeeding initiation time and the complications after 3 d of treatment were compared. Results Before treatment, there were no significant differences in the arterial partial pressure of oxygen（PaO2）, arterial partial pressure of carbon dioxide（PaCO2） and fraction of inspired oxygen（FiO2） between the two groups（P〈0.05）. After 3 d of treatment, the PaO2, PaCO2 and FiO2 in the two groups were significantly improved, and the improvement of the intermittent group were significantly better than those of the continuous group, the differences were statistically significant（P〈0.05）. The mechanical ventilation time and the time of oxygen therapy in the intermittent group were（76.24±5.91） h and（86.19±5.01） h respectively, which were significantly shorter than（98.33±9.73） h and（106.84±10.48） h in the continuous group, the differences were statistically signficant（P〈0.05）. The breastfeeding initiation time of the intermittent group was（47.18±6.10） h, which was significantly earlier than（54.37±5.08）h of the continuous group, the difference was statistically significant（P〈0.05）. The incidence of complications in the intermittent group was 13.89%（5/36）, which was significantly lower than 34.29%（12/35） in the continuous group, the difference was statistically significant（P〈0.05）. Conclusion NIPPV can effectively reduce the treatment time for children with NRDS, and the treatment effect is significant. It can effectively reduce the occurrence of CO2 retention, abdominal distention and other complications in the treatment of children, and improve the prognosis, which can be popularized in clinical practice.