常频机械通气和鼻塞式持续气道正压通气致早产儿支气管肺发育不良的临床比较

目的：调查早产儿支气管肺发育不良（BPD）的发病率，探讨常频机械通气（CMV）和鼻塞式持续气道正压通气（NCPAP）对早产儿BPD发病率的影响。方法收集安徽省立医院新生儿病房2013年1月1日至2013年12月31日收治的胎龄＜37周且存活≥28 d早产儿临床资料，根据患儿辅助通气情况，分为CMV组和NCPAP组；生后≥28 d仍然需要吸氧并伴有胸片改变定义为BPD，比较两组BPD的发病率。结果入选早产儿100例，CMV组50例，NCPAP组50例，两组在胎龄、性别、出生体重、住院时间、通气时间、妊娠史及合并疾病等方面差别无统计学意义（P＞0．05）。 BPD总体发病率为49．0％，CMV组BPD发病率明显高于NCPAP组，差别有统计学意义（ P＜0．01）。结论早产儿BPD的发病率仍然较高，CMV较NCPAP更易使早产儿发生BPD，避免CMV可明显降低早产儿BPD的发生，临床应尽量使用NCPAP帮助早产儿度过呼吸困难阶段。

Comparison of bronchopulmonary dysplasia between mechanical ventilation and NCPAP in premature infants

Objective To explore morbidity rate of bronchopulmonary dysplasia of premature infants in Anhui Provincial Hospital ,to determine the incidence of bronchopulmonary dysplasia affected by machinery ventilation and NCPAP in premature infants .Methods To prevent the occurrence of bronchopulmonary dysplasia ,data were retrospectively collected from NICU in Anhui Provincial Hospital between Jan.1,2013 to Dec.31,2013.All babies whose gestational age was ＆lt;37w and survived over 28d were included in this study . Babies were assigned into two groups according to ventilation ,machinery ventilation group and NCPAP group .BPD was defined as 28 d of oxygen therapy with radiographic changes .Clinical comparison of incidence of BPD was conducted between two groups .Results Al-together 100 preterm babies were included.Between the two groups,gestational age,gender,weight,hospital stays,duration of ventilation history of pregnancy,and complications were not significantly different （P＆gt;0.05）.The overall incidence of BPD was 49.0%.The inci-dence of BPD in CMV group was significantly higher than that in NCPAP group （P＆lt;0.01）.Conclusions The incidence of BPD was high in NICU of Anhui Provincial Hospital .In comparison with NCPAP ,CMV is more likely to cause BPD in premature infants ,the a-voidance of which can significantly decrease the incidence of BPD ,therefore ,NCPAP is a prior choice in clinic .