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目的评价经鼻间歇正压通气(NIPPV)与经鼻持续正压通气(NCPAP)治疗新生儿呼吸窘迫综合征(NRDS)的疗效。方法选择2010年1月至2011年11月入住河北省儿童医院新生儿重症监护室(NICU)的NRDS患儿66例,随机分为NIPPV组(32例)和NCPAP组(34例),分别于入院0、12、24、72h进行血气分析,比较氧合改善情况、氧疗时间、呼吸机使用时间及并发症和预后等。结果治疗开始时(入院0h)两组PaO2、PaCO2差异无统计学意义(P>0.05)。治疗12、24、72h后PaO2、PaCO2、P/F、a/APO2均有改善(P均<0.05),且NIPPV组改善情况优于NCPAP组,两组比较差异有统计学意义(P均<0.05)。两组患儿CO2潴留、腹胀发生率差异有统计学意义(P<0.05),且NIPPV组开奶时间较NCPAP组提前。NIPPV组经鼻通气治疗失败后改为插管行呼吸机通气率明显低于NCPAP组,差异有统计学意义(P<0.05)。结论 NIPPV较NCPAP能在短时间内明显改善肺部氧合功能,缩短无创辅助通气及氧疗时间,减少了CO2潴留、腹胀的发生率,且开奶时间提前,降低了气管插管呼吸机上机率。

Comparison of nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in the treatment of neonatal respiratory distress syndrome.

??Objective To evaluate the efficacy of nasal intermittent positive pressure ventilation??NIPPV?? treatment for neonatal respiratory distress syndrome??NRDS??. Methods Select 66 cases of NRDS and randomly divide them into NIPPV group ??32 cases??and NCPAP group ??34 cases??. After admission compare the improvement in oxygenation??duration of oxygen therapy??ventilator use??and complications. Results After treatment of 12 h??24 h??72 h??PaCO2 and PaO2 were improved??P??0.05????and NIPPV group were better than NCPAP group??the difference being statistically significant??P??0.05??. P/F and a/APO2 of the two groups showed some improvement after treatment .NIPPV group improved more significantly compared with NCPAP group??at 12 h?? 24 h and 72 h??the differences were statistically significant ??P??0.05??. The occurrence rate of CO2 retention and abdominal distension had statistical difference ??P??0.05??. In NIPPV group intubation and ventilator rate after nasal airway treatment failure was significantly lower than NCPAP group??the difference being statistically significant??P??0.05??. Conclusion Compared to NCPAP??NIPPV improves lung oxygenation function and shortens the oxygen therapy time in a short time??reducing CO2 retention and bloating??and moving feeding time.