经鼻间歇正压通气治疗新生儿呼吸窘迫综合征的临床研究

发布时间：2018-05-04 19:13

本文选题：新生儿呼吸窘迫综合征 + 经鼻间歇正压通气　；参考：《临床肺科杂志》2016年12期

【摘要】：目的探讨经鼻间歇正压通气(NIPPV)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效价值及安全性,以期更好的为临床决策与发展提供相关依据。方法通过运用前瞻性研究方法,对我院自2014年1月-2016年1月期间收治患有呼吸窘迫综合征的120例新生儿随机分组,分别采用经鼻间歇正压通气或经鼻持续气道正压通气(NCPAP)联合肺表面活性物质进行治疗,对两组患儿治疗后的临床疗效加以评价。比较指标包括:氧合指数(OI)、pH值、PaO_2、PaCO_2、治疗成功率、病死率、辅助通气时间及肺漏气率等。结果两组治疗后PaO_2、pH值、OI值均显著升高,PaCO_2显著降低(P0.05)。治疗1 h时:间歇组PaO_2、pH值、OI值均显著高于持续组(P0.05),两组PaCO_2差异无统计学意义(P0.05)。治疗12 h:两组PaO_2、PaCO_2、pH值、OI值差异无统计学意义(P0.05)。另外,NIPPV组的治疗成功率明显高于NCPAP组(P0.05),而NCPAP组的辅助通气时间明显高于NIPPV组(P0.05),病死率、肺气漏比较无明显统计学差异(P0.05)。结论 NIPPV作为一种新型的无创呼吸机械通气技术,治疗效果更优,起效时间更快,治疗成功率更高,在NRDS的治疗中将有着广阔的前景,值得进行推广。
[Abstract]:Objective to evaluate the efficacy and safety of nasal intermittent positive pressure ventilation (NIPPVV) in the treatment of neonatal respiratory distress syndrome (NRDS) in order to provide a better basis for clinical decision-making and development. Methods 120 neonates with respiratory distress syndrome admitted to our hospital from January 2014 to January 2016 were randomly divided into two groups by using a prospective study. Two groups of children were treated by transnasal intermittent positive airway pressure ventilation or nasal continuous positive airway pressure ventilation combined with pulmonary surfactant. The clinical effects of the two groups were evaluated. The comparative indexes included: oxygen index, pH value, Pao _ 2 / Paco _ 2, treatment success rate, mortality rate, auxiliary ventilation time and lung leakage rate, etc. Results after treatment, Paco _ 2 pH value and OI value increased significantly in both groups. At 1 h after treatment, the pH value of PaOstack in intermittent group was significantly higher than that in continuous group (P 0.05). There was no significant difference in PaCO_2 between the two groups (P 0.05). Treatment for 12 hours: there was no significant difference in pH value and OI between the two groups. In addition, the success rate of NIPPV group was significantly higher than that of NCPAP group (P 0.05), while the auxiliary ventilation time of NCPAP group was significantly higher than that of NIPPV group (P 0.05). Conclusion as a new type of non-invasive respiratory mechanical ventilation technique, NIPPV has better therapeutic effect, faster onset time and higher success rate. It will have a broad prospect in the treatment of NRDS and is worth popularizing.
【作者单位】：淮安市淮安医院儿科;靖江市人民医院儿科;江苏省第二中医院儿科;
【基金】：江苏省卫生厅科研课题基金支持项目(No LZ13098)
【分类号】：R722.1

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