可变流量NCPAP加氨茶碱治疗早产儿呼吸衰竭临床观察

目的探讨可变流量经鼻持续气道正压通气(VF-NCPAP)加氨茶碱治疗早产儿呼吸衰竭的疗效。方法将NICU收治的57例呼吸衰竭,早产儿分为:治疗组(VF-NCPAP加氨茶碱静注)23例、对照组A(传统NCPAP加氨茶碱静注)18例和对照组B(单用VF-NCPAP)16例。各自进行相应治疗,比较治疗后72 h内不同时间段呼吸参数改变及临床疗效。结果治疗8 h后,治疗组PaO2较对照组B上升明显,有显著的差异性(P<0.01);治疗组PaCO2较对照组A和对照组B下降明显,治疗组OI(PaO2/FiO2)较对照组B上升明显,均有显著的差异性(P<0.05)。治疗24 h后,治疗组PaO2较对照组A上升明显,有显著的差异性(P<0.05)。治疗48 h后,治疗组FiO2较对照组A和对照组B下降明显,有显著的差异性(P<0.05);治疗组OI较对照组A上升明显,有显著的差异性(P<0.01)。结论VF-NCPAP加氨茶碱治疗早产儿呼吸衰竭有较好的疗效,优于传统的NCPAP加氨茶碱或单用VF-NCPAP。

Clinical observation of variable-flow nasal continuous positive airway pressure and aminophylline in preterm neonates with respiratory failure

Objective To study the effects of variable-flow nasal continuous positive airway pressure(VF-NCPAP) and aminophylline on preterm neonates with respiratory failure.Methods Fifty-seven preterm neonates with respiratory failure were divided into 3 groups in NICU.Group 1(n=23)was treated with VF-NCPAP and aminophylline.Group 2(n=18)with traditional NCPAP and aminophylline.Group 3(n=16)with VF-NCPAP.Observing the clinical effects by comparing respiratory parameters during 72 h therapy.Results After 8 htherapy,PaO_2 of group 1 was higher than group 3(P<0.01),PaCO_2 of group 1 was lower than group 2 and group 3(P<0.05),OI(PaO_2/FiO_2)of group 1 was higher than group 3(P<0.05),they were significant.After 24 h-therapy,it was significant that PaO_2 of group 1 was higher than group 2(P<0.05);After 48 h-therapy,it was significant that FiO_2 of group 1 was lower than group 2 and group 3(P<0.05),OI of group 1 was higher than group 2(P<0.01).Conclusion VF-NCPAP with aminophylline was a beneficial method in preterm neonates with respiratory failure.It is better than either traditional NCPAP and aminophylline or VF-NCPAP.