BiPAP及nCPAP两种无创通气模式在RDS早产儿的随机对照研究

目的：探究BiPAP及nCPAP两种无创通气模式在呼吸窘迫综合征(RDS)早产儿随机对照的临床效果。方法：选取2016年6月～2017年5月在我院NICU接受治疗的85例RDS早产儿,按随机数字表法将其分为对照组(42例)和研究组(43例)。对照组采用持续气道正压通气法(nCPAP),研究组采用双水平气道正压通气法(BiPAP)。对比两组不同时间点呼吸机参数(吸入氧体积分数FiO2、PEEP/EPAP、PaO2/FiO2值)及动脉血气分析参数(pH值、动脉血二氧化碳分压PaCO2、动脉血氧分压PaO2)。结果：两组治疗前FiO2、PEEP/EPAP、PaO2/FiO2、pH值、PaCO2、PaO2水平无明显差异(P＞0.05)。治疗24h后,研究组FiO2、PEEP/EPAP水平较对照组降低,而PaO2/FiO2水平较对照组升高,差异具有统计学意义(P＜0.05)；治疗12h、24h后,研究组pH值、PaO2水平较对照组升高,而PaCO2水平较对照组降低,差异具有统计学意义(P＜0.05)。结论：BiPAP较nCPAP在改善RDS早产儿短期预后方面更具优势,可改善患儿肺换气功能,促进氧合,值得临床上推广运用。

A randomized controlled trial of two noninvasive ventilation modes of BiPAP and nCPAP in preterm infants with RDS

Objective: To explore the clinical effect of two noninvasive ventilation modes of Bi-level positive airway pressure ventilation (BiPAP) and continuous positive airway pressure (nCPAP) in preterm infants with respiratory distress syndrome (RDS). Methods: Eighty-five preterm infant with RDS who treated in the NICU department of our hospital from June 2016 to May 2017 were selected and randomly divided into the control group (n=42) and the research group (n=43). The infants in the control group were given nCPAP, and the infants in the research group were given BiPAP. The ventilator parameters, including inhalation oxygen volume fraction (FiO2), PEEP/EPAP, and PaO2/FiO2 values, and the arterial blood gas analysis parameters, including pH value, arterial blood carbon dioxide partial pressure (PaCO2), and arterial oxygen partial pressure (PaO2) at different time points of two groups were compared. Results: There were no significant differences in FiO2, PEEP/EPAP, PaO2/FiO2, pH, PaCO2 and PaO2 before treatment between two groups (P>0.05). After treated for 24 hours, the FiO2 and PEEP/EPAP levels in the research group were lower than those in the control group, while the PaO2/FiO2 level in the research group was higher than that in the control group, and the differences were statistically significant (P<0.05). After treated for 12 and 24 hours, the pH and PaCO2 levels in the research group were higher than those in the control group, while the PaCO2 level in the research group was lower than that in the control group, and the differences were statistically significant (P<0.05). Conclusions: BiPAP has an advantage over nCPAP in improving the short-term prognosis of preterm infants with RDS, it can improve lung ventilation and promote oxygenation in children, which is worthy of clinical application.