经鼻双相正压通气治疗早产儿呼吸暂停临床观察

Clinical observation on the treatment of premature infants with apnea by nasal biphasic positive pressure ventilation

目的观察使用经鼻双相正压通气对治疗早产儿呼吸暂停的临床效果。方法选取2017年10月至2018年6月我院治疗的86例原发性及继发性呼吸暂停早产儿,随机数字表法分为治疗组及对照组,分别使用经鼻双相正压通气(biphasic)和经鼻持续气道正压通气(nasal continuous positive airway pressure,NCPAP)治疗,两组患儿性别、胎龄、出生体质量、产前使用激素、分娩方式方面比较,差异无统计学意义(P>0.05),统计学分析两组无创通气时间、并发症、改用有创机械通气例数、吸氧时间、继发感染和动脉导管未闭发生率。结果经鼻双相正压通气治疗组患儿与NCPAP对照组比较,其无创通气时间、并发症、改用有创机械通气例数和吸氧时间明显减少,两组比较差异均有统计学意义(P<0.05);而两组继发感染和动脉导管未闭发生率比较,差异无统计学意义(P>0.05)。结论经鼻双相正压通气相比于NCPAP,具有一定优势,可替代NCPAP作为早产儿呼吸暂停的首选治疗措施之一,及早使用可减少并发症的发生,并可避免应用有创机械通气。

Objects To observe the clinical effect of transnasal biphasic positive pressure ventilation in the treatment of premature infants with apnea.Methods Selection in October 2017 to June 2018,the hospital treatment of 86 cases of primary and secondary apnea premature,which was divided into two groups by random number table respectively applied nasally dual phase positive pressure ventilation(Biphasic)and Nasal continuous positive airway pressure(NCPAP)treatment,two groups of children with gender,gestational age,birth weight,antenatal corticosteroids,childbirth way,there was no statistically significant difference(P>0.05).The non-invasive ventilation time,complications,cases of switching to invasive mechanical ventilation,oxygen inhalation time,secondary infection and incidence of patent ductus arteriosus were analyzed.Results Children treated with nasal biphasic positive pressure ventilation were compared with NCPAP control group,its non-invasive ventilation time,complications,cases of switching to invasive mechanical ventilation and oxygen absorption time were significantly reduced,the differences between the two groups were statistically significant(P<0.05);there was no statistically significant difference in the incidence of secondary infection and patent ductus arteriosus between the two groups(P>0.05).Conclusion Compared with NCPAP,transnasal biphasic positive pressure ventilation has obvious advantages,which can replace NCPAP as one of the first treatment measures for premature infants with apnea.Early use can reduce the occurrence of complications and avoid the use of invasive mechanical ventilation.