经鼻双水平正压通气在早产儿呼吸窘迫综合征中的应用进展

Progressive of bi-level positive airway pressure ventilation in preterm infants with respiratory distress syndrome

呼吸窘迫综合征(RDS)主要发生于早产儿,且胎龄越小,发生率越高。目前,早产儿RDS的治疗方案包括产前预防、产后肺表面活性物质的使用和呼吸支持等对症治疗。有创呼吸支持挽救了大量RDS患儿生命,但易引发呼吸机相关性肺炎、支气管肺发育不良等并发症。近年来为了减少有创机械通气引发的一系列并发症,越来越多的早产儿RDS的初始治疗使用经鼻持续正压通气(NCPAP)。鉴于NCPAP临床应用的局限性,以及呼吸机和经鼻连接技术的不断改进,经鼻双水平气道正压通气(Bi PAP)得到了广泛的应用。本文重点介绍经鼻Bi PAP在早产儿RDS中的应用。

Respiratory distress syndrome mainly occurs in preterm infants. The incidence of RDS is related inversely to the gestational age. At present,the treatment of RDS includes antenatal prevention,postnatal pulmonary surfactant and respiratory supporting. A large amount of RDS infants have been saved successfully by using invasive ventilation. However,this kind of ventilation may easily leads to many complications,such as ventilator-associated pneumonia, bronchopulmonary dysplasia and so on. Recently, in order to reduce the complications of invasive ventilation,NCPAP is used in RDS infants initially. Because of the disadvantages of NCPAP and the improvement of mechanical ventilation and nasal breathing connected to the interface,bi-level positive airway pressure ventilation is more widely used. This article focuses on Bi PAP application of RDS in premature infants.