NIPPV在治疗早产儿和极度不成熟儿呼吸窘迫综合征中的疗效分析

Analysis of the efficacy of NIPPV in the treatment of respiratory distress syndrome in premature infants and extremely immature infants

目的研究经鼻间歇正压通气(NIPPV)在早产儿和极度不成熟儿呼吸窘迫综合症治疗中的疗效及安全性。方法采用随机对照法将140例确诊为呼吸窘迫综合症的早产儿和极度不成熟儿分为实验组及对照组,各70例,实验组予以NIPPV初始给氧联合肺表面活性物质治疗,对照组予NCPAP初始给氧联合肺表面活性物质治疗。比较两组患儿血气改善情况,呼吸暂停、支气管肺发育不良(BPD)、肺出血、早产儿视网膜病变(ROP)及腹胀的发生率,通过以上指标,判断NIPPV作为无创辅助通气在治疗早产儿和极度不成熟儿呼吸窘迫综合征是否疗效更好和更安全。结果通过比较,两组患儿氧合改善差异无统计学意义,但NIPPV在治疗早产儿和极度不成熟儿呼吸窘迫综合症患儿中降低PCO2效果优于NCPAP,且未增加腹胀及肺出血发生率,而呼吸暂停、BPD及ROP发生率NIPPV组比较NCPAP组更低。结论NIPPV在早期早产儿和极度不成熟儿呼吸窘迫综合症治疗中安全、有效,比NCPAP效果更佳。

Objective To analyse the efficacy and safety of nasal intermittent positive pressure ventilation(NIPPV)in the treatment of respiratory distress syndrome in premature and extremely immature infants.Methods 140 premature infants and extremely immature infants diagnosed as respiratory distress syndrome were randomly divided into experimental group(n=70)and control group(n=70).The experimental group was treated with NIPPV initial oxygen combined with pulmonary surfactant therapy,and the control group was treated with NCPAP initial oxygen combined with pulmonary surfactant therapy.The improvement of blood gas and the incidence of apnea,bronchopulmonary dysplasia(BPD),pulmonary hemorrhage,retinopathy of prematurity(ROP)and abdominal distension were compared between the two groups,and whether NIPPV is more effective and safe as a non-invasive ventilation in the treatment of respiratory distress syndrome of premature and extremely immature infants was further analyzed.Results There was no significant difference in the improvement of oxygenation between the two groups,but the effect of NIPPV in reducing PCO2 was better than that of NCPAP in the treatment of premature and extremely immature respiratory distress syndrome,and did not increase the incidence of abdominal distension and pulmonary hemorrhage,while the incidence of apnea,BPD and ROP in NIPPV group was lower than that in NCPAP group.Conclusion NIPPV is safe and effective in the treatment of early premature and extremely immature respiratory distress syndrome,and it is more effective than NCPAP.