两种无创正压通气模式联合固尔苏治疗新生儿呼吸窘迫综合征的效果比较

目的探讨两种无创正压通气模式联合猪肺磷脂注射液(商品名:固尔苏)治疗新生儿呼吸窘迫综合征的效果。方法100例呼吸窘迫综合征患儿,依据治疗方式不同分为治疗A组和治疗B组,各50例。治疗A组行鼻塞式持续气道正压通气(NCPAP)模式联合固尔苏治疗,治疗B组行双水平气道正压通气(BiPAP)模式联合固尔苏治疗,比较两组治疗前后的动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)及无创通气时间、氧疗时间、临床症状缓解时间、住院时间及治疗效果。结果治疗后,治疗A组的PaO2(59.0±5.4)mm Hg(1 mm Hg=0.133 kPa)低于治疗B组的(64.7±5.2)mm Hg,PaCO2(44.2±5.0)mm Hg高于治疗B组的(36.4±4.2)mm Hg,差异有统计学意义(P<0.05)。治疗A组无创通气时间(7.3±3.1)d、氧疗时间(12.4±6.2)d、临床症状缓解时间(3.8±0.6)d、住院时间(16.9±7.1)d均长于治疗B组的(4.5±2.6)、(7.7±3.3)、(1.8±0.4)、(12.7±4.2)d,差异有统计学意义(P<0.05)。治疗A组临床治疗有效率72.0%低于治疗B组的98.0%,差异有统计学意义(χ^2=13.25,P<0.05)。结论BiPAP通气模式联合固尔苏治疗新生儿呼吸窘迫综合征,PaO2水平改善明显,缩短治疗时间,提高了临床效率。

Comparison of two noninvasive positive pressure ventilation modes combined with Curosurf in the treatment of neonatal respiratory distress syndrome

Objective To discuss the effect of two noninvasive positive pressure ventilation modes combined with poractant alfa injection(trade name:Curosurf)in the treatment of neonatal respiratory distress syndrome.Methods A total of 100 cases of neonatal respiratory distress syndrome were divided into treatment group A and treatment group B by different treatment methods,with 50 cases in each group.Treatment group A was treated by nasal continuous positive airway pressure(NCPAP)mode combined with Curosurf,and treatment group B was treated by bi-level positive airway pressure(BiPAP)mode combined with Curosurf.The partial pressure of oxygen(PaO2)and partial pressure of carbon dioxide(PaCO2)before and after treatment,noninvasive ventilation time,oxygen therapy time,clinical symptom relief time,hospitalization time and treatment effect was compared between the two groups.Results After treatment,PaO2(59.0±5.4)mm Hg(1 mm Hg=0.133 kPa)in treatment group A was lower than(64.7±5.2)mm Hg in treatment group B,and PaCO2(44.2±5.0)mm Hg was higher than(36.4±4.2)mm Hg in treatment group B.Their difference was statistically significant(P<0.05).The noninvasive ventilation time,oxygen therapy time,clinical symptom relief time,hospitalization time were(7.3±3.1),(12.4±6.2),(3.8±0.6)and(16.9±7.1)d in treatment group A,which was longer than(4.5±2.6)、(7.7±3.3)、(1.8±0.4)、(12.7±4.2)d in treatment group B,and their difference was statistically significant(P<0.05).The total effective rate of clinical treatment 72.0%in treatment group A was lower than 98.0%in treatment group B,and the difference was statistically significant(χ^2=13.25,P<0.05).Conclusion BiPAP ventilation combined with Curosurf can significantly improve the level of PaO2,shorten the treatment time and improve the clinical efficiency.