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目的:比较经鼻间歇正压通气(NIPPV)与经鼻持续气道正压通气(n CPAP)对早产儿呼吸窘迫综合征(RDS)的疗效。方法:选择2013年4月至2015年3月在我院新生儿重症监护病房住院的RDS早产儿作为研究对象,按随机数字表法将研究对象随机分为NIPPV组(51例)和n CPAP组(57例),所有患儿均常规使用注射用牛肺表面活性剂(珂立苏,华润双鹤药业股份有限公司)70 mg/kg,比较两组患儿动脉血气分析结果、治疗成功率、使用NIPPV和n CPAP时间、主要并发症及其预后结局。结果:两组患儿在性别、胎龄、出生体质量、5 min Apgar评分、RDS分级、产前是否使用激素及生后使用PS情况等方面比较差异无统计学意义(P均>0.05)。NIPPV组治疗成功45例,治疗成功率88.24%,n CPAP组治疗成功41例,治疗成功率71.93%(P<0.05)。NIPPV组治疗后2 h、12 h的p H、Pa CO2、Pa O2比n CPAP组改善更明显(P<0.05)。NIPPV组与n CPAP组治疗时患儿平均使用NIPPV和n CPAP的时间比较差异无统计学意义(P>0.05)。NIPPV组呼吸暂停发生率明显低于n CPAP组,差异有统计学意义(P<0.05)。结论:NIPPV治疗早产儿RDS效果优于n CPAP。
Objective: To compare the efficacy of nasal intermittent positive pressure ventilation (NIPPV) and nasal continuous positive airway pressure (n CPAP) on respiratory distress syndrome (RDS) in preterm infants. METHODS: Preterm infants with RDS admitted to neonatal intensive care unit in our hospital from April 2013 to March 2015 were randomly divided into NIPPV group (n = 51) and nCPAP group (57 cases). All children were routinely given 70 mg / kg bovine pulmonary surfactant (Kelaisu, China Shuanghe Pharmaceutical Co., Ltd.). The results of arterial blood gas analysis in two groups were compared, and the success rate of treatment , Use of NIPPV and n CPAP time, major complications and their prognosis. Results: There was no significant difference in sex, gestational age, birth weight, 5 min Apgar score, RDS grading, whether or not hormone was used before delivery and postnatal use of PS in both groups (all P> 0.05). In the NIPPV group, 45 cases were successfully treated, with a success rate of 88.24%. In the nCPAP group, 41 cases were successfully treated, with a success rate of 71.93% (P <0.05). The levels of p H, PaCO 2 and Pa O 2 at 2 h and 2 h after NIPPV treatment improved more significantly than n CPAP group (P <0.05). There was no significant difference in the average time between using NIPPV and n CPAP in NIPPV group and n CPAP group (P> 0.05). The incidence of apnea in the NIPPV group was significantly lower than that in the n CPAP group (P <0.05). Conclusion: NIPPV treatment of preterm children RDS better than n CPAP.