双水平正压通气在早产儿呼吸窘迫综合征的临床应用

Clinical application of bi-level positive airway pressure in premature infants with respiratory distress syndrome

目的探讨双水平正压通气(BiPAP)治疗早产儿呼吸窘迫综合征的临床疗效。方法选取2019年3月~2020年2月在我院新生儿科诊断为呼吸窘迫综合征的早产儿68例,随机分为BiPAP组39例和经鼻持续气道正压通气(nCPAP)组29例,采用气管插管应用肺表面活性物质(PS)-拔出气管插管技术,监测呼吸支持后1h、24h及72h的血气,血氧分压(PaO2)、二氧化碳分压(PaCO2)及氧合指数(OI);统计分析两组患儿发生支气管肺发育不良、颅内出血、早产儿视网膜病等并发症的例数。结果BiPAP组在无创呼吸支持后1h、24h及72h的PaO2、OI均高于nCPAP组,PaCO2值均低于nCPAP组,差异有统计学意义(P<0.05)。两组支气管肺发育不良、颅内出血、早产儿视网膜病发生率比较,差异均无统计学意义(P>0.05)。结论BiPAP模式治疗早产儿呼吸窘迫综合征疗效确切,且效果优于nCPAP。

Objective To investigate the clinical efficacy of bi-level positive airway pressure(BiPAP)in premature infants with respiratory distress syndrome.Methods From March 2019 to February 2020,68 premature infants diagnosed with respiratory distress syndrome admitted to our hospital's neonatology department were randomly divided into the BiPAP group(n=39)and the nasal continuous positive airway pressure(nCPAP)group(n=29).Pulmonary surfactant(PS)-extubation technique was used for tracheal intubation.Blood gas,PaO2,PaCO2 and OI were monitored at 1h,24h and 72h after respiratory support.Statistics of the two groups of children with bronchopulmonary dysplasia,intracranial hemorrhage,retinopathy of prematurity and other complications were analyzed.Results The values of PaO2 and OI of the BiPAP group were higher than those of the nCPAP group at 1h,24h and 72h after the non-invasive respiratory support,the PaCO2 value was lower than that of the nCPAP group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of bronchopulmonary dysplasia,intracranial hemorrhage and retinopathy of prematurity between the two groups(P>0.05).Conclusion The BiPAP model is effective in treating respiratory distress syndrome of premature infants,and the efficacy is better than nCPAP.