nIPPV与nCPAP联合猪肺磷脂注射液治疗早产儿呼吸窘迫综合征的临床疗效比较

Comparison of clinical efficacy of nIPPV and nCPAP combined with curosurf in the treatment of respiratory distress syndrome in premature infants

目的探究经鼻间歇正压通气(nIPPV)与经鼻持续气道正压通气(nCPAP)联合肺表面活性物质(猪肺磷脂注射液)在新生儿呼吸窘迫综合征(NRDS)中的临床疗效,以期为NRDS提供一种安全有效的治疗方法。方法选取2017年6月至2018年10月本院NICU收治的100例NRDS早产儿,随机分为观察组和对照组,各50例。在给予猪肺磷脂注射液治疗的同时,观察组和对照组分别予nIPPV和nCPAP辅助通气,比较两组患儿临床疗效及不良反应的发生情况。结果观察组和对照组治疗后1、12 h血气分析指标pH、PaO2、PaCO2均较治疗前明显改善,差异有统计学意义(P<0.05);观察组与对照组相比,差异有统计学意义(P<0.05)。在不良反应发生率方面,观察组患儿呼吸暂停情况明显改善,与对照组相比差异有统计学意义(P<0.05),在呼吸机相关性肺炎、腹胀、气胸等方面,两组比较差异无统计学意义。结论 nIPPV联合猪肺磷脂注射液治疗早产儿NRDS的临床疗效明显优于nCPAP联合猪肺磷脂注射液,且安全性高,值得临床推广。

Objective To compare the clinical efficacy of nasal intermittent positive pressure ventilation(nIPPV) and nasal continuous positive airway pressure ventilation(nCPAP) combined with pulmonary surfactant(curosurf) in neonatal respiratory distress syndrome(NRDS), in order to provide a safe and effective treatment for NRDS. Methods 100 children with NRDS in NICU of our hospital from June 2017 to October 2018 were randomly divided into observation group(n=50) and control group(n=50). Both groups were given curosurf treatment routinely, while the observation group and the control group were given nIPPV and nCPAP treatment respectively. Clinical efficacy and incidence of adverse reactions between the two groups were compared. Results After 1 and 12 h of treatment, both groups had better pH value, partial pressure of oxygen(PaO2) and partial pressure of carbon dioxide(PaCO2) than before treatment, and their difference was statistically significant(P<0.05). Compared with the control group, the improvement of the above indicators was more obvious in the observation group, and the difference was statistically significant(P<0.05). In the incidence of adverse reactions, the observation group with apnea improved significantly(P<0.05), compared with the control group,there was no significant difference in ventilator-associated pneumonia, abdominal distention, pneumothorax and other aspects between the two groups. Conclusion The clinical efficacy of nIPPV combined with curosurf in the treatment of NRDS in premature infants is significantly better than that of nCPAP combined with curosurf, and it is safe and worthy of clinical promotion.