肺复张联合DuoPAP治疗早产儿呼吸窘迫综合征

目的：探讨肺复张联合Duo PAP治疗早产儿呼吸窘迫综合征的临床疗效。方法选取2013年6月1日-2014年6月30日收入我院NICU室的呼吸窘迫综合征早产儿患者68例，随机分为2组，实验组患儿入院后立即给予DuoPAP呼吸支持，呼吸支持24 h内给予肺复张（LRM），间隔8 h给予1次RM，连续3 d。对照组给予管插管机械通气治疗。结果得出实验组肺复张联合DuoPAP治疗总有效率为91.1%高于对照组的70.5%，有统计学意义（P〈0.05）；治疗12h后对照组和观察组动脉血氧分压分别为的（149.2±19.7）mmHg和（162.3±18.1）mmHg；通气72 h后呼吸机参数对照组和观察组的潮气量分别为（427.2±78.5）mL和（503.6±93.2） mL；对照组和观察组的住院情况和治疗效果比较，主要包括住院天数分别为对照组的（32.2±6.8）d和肺复张联合DuoPAP治疗组的（25.9±5.1）d及死亡病例数分别为2例和0例。以上数据结果具有明显统计学意义（P〈0.05）。结论肺复张联合Duo PAP治疗早产儿呼吸窘迫综合征可有效改善患者的氧合功能，明显提高患者肺的顺应性，大幅降低呼吸机的使用条件，显著提高新生儿呼吸窘迫征的抢救成功率，降低插管率、撤机失败率、BPD、气漏及呼吸机相关性肺炎的发病率，缩短氧暴露时间，减少呼吸机应用时间和住院费用。是临床医师治疗早产儿NRDS首选的无创通气联合治疗方式，简便易行，耐受性好，具有临床推广应用的潜力。

A combined DuoPAP in the treatment of premature infants with respiratory distress syndrome complex lung

Objective To investigate the clinical effect of lung recruitment and Duo syndrome PAP in treatment of premature res-piratory distress.Methods From June 1, 2013 to June 30, 2014 in our hospital NICU room income of premature infants with respi-ratory distress syndrome in patients with 68 cases, were randomly divided into 2 groups, the experimental group were given DuoPAP respiratory support immediately after admission, respiratory support within 24 hours to lung recruitment maneuver （LRM）, interval of 8 h to 1 RM, 3 d. The control group was given tube intubation and mechanical ventilation in the treatment. Results The experimental group of lung recruitment and DuoPAP treatment, the total effective rate was 91.1% higher than that of the control group was 70.5%, there was statistical significance （P〈0.05）; control group after the treatment of 12h combined arterial partial pressure of oxygen were （149.2±19.7）mmHg and （162.3±18.1）mmHg; tidal volume ventilation after 72 h of ventilator parameters in control group and observation group is（427.2±78.5）mL and（503.6±93.2） mL respectively; compared with control effect of hos-pitalization and treatment group and observation group, including hospitalization days were the control group （32.2±6.8） days and the lung recruitment and DuoPAP treatment group,（25.9±5.1） and the number of deaths were 2 cases and 0 cases of. The above data was statistically significant （P〈0.05）.Conclusion Lung recruitment and Duo PAP in the treatment of premature infants with respiratory distress syndrome can effectively improve oxygenation function of patients, significantly improve patient compliance of the lung, greatly reduce the use of respirator, significantly improve the neonatal respiratory distress syndrome in the successful rescue rate, decrease the incidence rate of intubation, weaning failure rate, BPD, gas leakage and ventilator pneumonia rate, shorten the exposure time, reduce ventilator time and hospitalization expenses. Clinicians treating pre