早产儿RDS撤机后不同模式无创通气治疗的临床研究

Clinical study of different kinds of non-invasive respiratory support after premature RDS withdrawal

观察早产儿呼吸窘迫综合征(RDS)撤机后不同模式无创通气治疗的疗效与安全性。选择三家医院需要机械通气的120例RDS早产儿作为研究对象。患儿撤机后随机分为:NCPAP组、SNIPPV组和序贯治疗组,观察无创通气时间、72 h内再插管率、1周内无创撤机成功率、氧疗时间、住院时间及并发症发生率等指标。与NCPAP组相比,SNIPPV组及序贯治疗组的72 h内再插管率明显降低、1周内无创撤机成功率明显升高(P<0.05).三组无创通气时间、氧疗时间、住院时间、并发症发生率等指标差异无统计学意义(P>0.05)。RDS早产儿撤机后SNIPPV序贯NCPAP模式是一种相对安全、有效的通气方式。

To observe the elinical eficacy and security of different kinds of non-invasive respiratory support in ex-tubated preterm infants with respiratory distress syndrome(RDS).Choosing 120 preterm infants from three hospi-tals,and those children with RDS all requiring mechanical ventilation.After evacuation,the children were randomly divided into:nasal continuous positive pressure ventilation(NCPAP)group,simultaneous nasal positive pressure ventilation(SNIPPV)group and SNIPPV continuous NCPAP treatment group.The children were observed of non-invasive ventil ation time,reintubation rate within 72 hours,non-invasive ventilation success rate within one week,time of oxygen therapy,length of hospital stay and complication rate.Compared with the NCPAP group,the success rate of extubation and removing non-invasive ventilation within one week in the SNIPPV group and the continuous treatment group was signifcantly higher(P<0.05).There was no significant difference between the three groups in non-invasive ventilation time,oxygen therapy time,hospitalization time and complication rate(P>0.05).SNIPPV continuous NCPAP mode after mechanical ventilation in RDS preterm infants is a relatively safe and effective venti-lation method.