nIPPV序贯通气在新生儿呼吸窘迫综合征早产儿撤机方案中的应用研究

Application of nIPPV sequential ventilation in the weaning plan of premature infants with neonatal respiratory distress syndrome

目的探究nIPPV序贯通气在新生儿呼吸窘迫综合征(NRDS)早产儿撤机方案中的应用效果。方法选取2017年1月至2019年12月于本院NICU接受常频通气的NRDS早产儿118例作为研究对象,随机分为观察组(n=65)和对照组(n=53)。观察组适当放宽撤机标准,对照组严格按照标准撤机,两组撤机后均予nIPPV过渡,比较两组撤机成功率和并发症发生率。结果观察组有创通气时间为(37.45±18.04)h,明显短于对照组的(70.36±20.03)h,差异有统计学意义(P<0.05);两组撤机成功率及无创通气时间比较差异无统计学意义。两组呼吸机相关性肺炎和通气后气漏发生率比较差异无统计学意义;撤机后,两组呼吸暂停发生率和支气管肺发育不良(BPD)发生率比较差异无统计学意义。结论新生儿呼吸窘迫综合征患儿可适当提前撤机并予nIPPV序贯通气过渡,不增加医疗风险,值得临床推广应用。

Objective To explore the effect of nIPPV sequential ventilation in the weaning plan of premature infants with neonatal respiratory distress syndrome(NRDS).Methods 118 children with NRDS who were ventilated regularly in the NICU of our hospital from January 2017 to December 2019 were selected as the research subjects,and they were randomly divided into the observation group(n=65)and the control group(n=53).The observation group appropriately relaxed the weaning standard,and the control group was weaned strictly according to the standard.After weaning,both groups were given nIPPV transition.The success rate of weaning and the incidence of complications were compared between the two groups.Results The invasive ventilation time in the observation group was(37.45±18.04)h,which was significantly shorter than(70.36±20.03)h in the control group,and the difference was statistically significant(P<0.05);there was no statistically significant difference in the success rate of weaning and the time of noninvasive ventilation between the two groups.There was no statistically significant difference in the incidence of ventilator-associated pneumonia and post-ventilation between the two groups.After weaning,there was no significant difference in the incidence of apnea and bronchopulmonary dysplasia(BPD)between the two groups.Conclusion Premature infants with NRDS can be weaned early and given nIPPV sequential ventilatory transition,which does not increase the medical risk and is worthy of clinical application.