NCPAP在NRDS患儿撤机后的应用价值

目的:探讨在NRDS患儿的撤机过程中,采用NCPAP过渡是否比直接脱机更能提高撤机的成功率.方法:将机械通气的NRDS患儿随机分成NCPAP过渡组和直接脱机组,比较两组的撤机成功率和用氧天数,并观察两组呼吸暂停、呼吸机相关性肺炎、新生儿败血症、气漏、动脉导管未闭、脑室内出血、脑室周围白质软化、坏死性小肠结肠炎、早产儿视网膜病、慢性肺疾病等并发症的发生率.结果:NCPAP过渡组45个患儿有41个成功撤机(占91.1%),直接脱机组36个患儿有25个成功撤机(占69.4%),两者差异有显著性(P＜0.05);总用氧时间两组无差别;并发症方面,两组发生呼吸暂停的次数有显著差别.结论:在NRDS患儿撤机时使用NCPAP过渡模式比直接脱机更有效.

Applied value of nasal continuous positive airway pressure in the neonatal respiratory distress syndrome of premature infants

Objective: To evaluate whether nasal continuous positive airway pressure (NCPAP) in preterm infants being ventilated for neonatal respiratory distress syndrome (NRDS) will increase weaning achievement ratio compared with weaning directly. Methods:Infants ventilated for NRDS were randomized to either NCPAP transition group or directly weaning group. The weaning achievement ratio between two groups was compared and the incidences of complieation of apnea, VAP, neonatal septicemia, frequent hemorrhoid, PDA, IVH, PVL, NEC, ROP and CLD of two groups were observed. Results:41(91.9%) of 45 infants were extubated successfully with the use of NCPAP versus 25 (69.4%) of 36 with extubated directly(P <0.05). There was a significant difference in apnea in the two groups during the 72-hour study period. The whole time of depending on oxygen in two groups has no difference. Conclusions:NCPAP is more effective than wean directly in weaning infants with NRDS from the ventilator.