经鼻间歇与持续正压通气治疗新生儿呼吸窘迫综合征的对照研究

目的对比经鼻间歇正压通气和经鼻持续气道正压通气治疗新生儿呼吸窘迫综合征的疗效和安全性。方法选择新生儿呼吸窘迫综合征90例,随机分为间歇组和持续组各45例,分别采用经鼻间歇正压通气和经鼻持续气道正压通气治疗。对比两组治疗后血气分析及相关参数、治疗效果及并发症发生率。结果两组治疗后Pa O2、PH值均显著升高,Pa CO2显著降低（P〈0.05）。治疗1 h间歇组Pa O2、PH值均显著高于持续组（P〈0.05）,两组Pa CO2差异无统计学意义（P〉0.05）。治疗12 h两组Pa O2、Pa CO2、PH值差异无统计学意义（P〉0.05）。两组治疗后Fi O2、MAP均显著降低,OI显著升高（P〈0.05）。治疗1 h、12 h间歇组OI均显著高于持续组（P〈0.05）,治疗12 h间歇组Fi O2显著低于持续组（P〈0.05）。间歇组治疗成功率显著高于持续组,氧暴露时间、气管插管机械通气时间显著短于持续组（P〈0.05）。间歇组呼吸机相关性肺炎、支气管肺发育不良发生率显著低于持续组（P〈0.05）。结论经鼻间歇正压通气治疗新生儿呼吸窘迫综合征相较经鼻持续气道正压通气可更迅速改善患儿通气和氧合,降低氧暴露时间和气管插管机械通气时间,并可能有助于降低呼吸机相关性肺炎、支气管肺发育不良发生率。

Randomized controlled study of nasal intermittent and continuous positive pressure ventilation in treatment of neonatal respiratory distress syndrome

Objective To compare the efficacy and safety of nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure ventilation neonatal respiratory distress syndrome. Methods All 90 cases of neonatal respiratory distress syndrome were randomly divided into groups of intermittent and continuous group,and each group had 45 cases,respectively used treatment of nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure therapy.After treatment,blood gas analysis,comparison and related parameters,treatment and complication rates of two groups were compared. Results After treatment,Pa O2,PH values of two groups were significantly increased,Pa CO2 were significantly decreased（P〈0.05）. After 1 h treatment,Pa O2,PH values of intermittent group were significantly higher than continuous group（P〈0.05）. After 12 h treatment, Pa O2, Pa CO2, PH value of between two groups were not statistically significant（P〉0.05）. After treatment,Fi O2,MAP of two groups were decreased significantly, OI were significantly increased（P〈0.05）. After 1 h,12 h treatment, OI of intermittent group were significantly higher than continuous group（P〈0.05）, after treatment 12 h,Fi O2 of intermittent group were significantly lower than continuous group（P〈0.05）. The success rate of intermittent group was significantly higher than continuous group, oxygen exposure time and MVET time were lower than continuous group（P〈0.05）.The ventilator-associated pneumonia,bronchopulmonary dysplasia incidence of intermittent group were significantly lower than continuous group（P〈0.05）.Conclusion Nasal intermittent positive pressure ventilation in treatment of neonatal respiratory distress syndrome compared to nasal continuous positive airway pressure,might be more rapid improvement in children with ventilation and oxygenation,reduces oxygen exposure time and MVET time, and might help reduce the incidence of ventilator associated pneumonia and bronchopulmonary dysp