ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (4): 315-318.doi: 10.3969/j.issn.1674-3865.2017.04.013

• 临床研究 • 上一篇    下一篇

鼻塞式间歇与持续正压通气在极低出生体重早产新生儿呼吸窘迫综合征的比较

詹群亮，凌华，林琳，陈志伟   

  1. 515021 广东 汕头，汕头市第二人民医院儿科
  • 出版日期:2017-08-25 发布日期:2017-12-08
  • 通讯作者: 詹群亮，E-mail:lqzhan@163.com
  • 作者简介:詹群亮（1980-），男，主治医师。研究方向：新生儿疾病的诊治

Comparison of the effects of nasal intermittent positive pressure ventilation with continuous positive airway pressure for neonatal respiratory distress syndrome in very-low-birth-weight preterm infants

ZHAN Qunliang，LING Hua，LIN Lin，CHEN Zhiwei   

  1. The Second People's Hospital of Shantou City，Shantou 515021，China
  • Online:2017-08-25 Published:2017-12-08

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摘要：
目的
针对极低出生体重的早产新生儿分别进行鼻塞式间歇正压通气(NIPPV)与鼻塞式持续正压通气(NCPAP)，对比呼吸支持治疗参数和并发症情况。
方法
选择2015年1月至2016年6月汕头市第二人民医院儿科收治住院的极低出生体重的早产新生儿80例为研究对象，随机分为NIPPV组和NCPAP组各40例。详细观察并记录患儿的无创呼吸支持时间、总用氧时间、72 h内需气管插管进行更换有创通气的使用率和肺表面活性物质的使用率以及并发症的发生情况。
结果
NCPAP组早产呼吸窘迫患儿72 h内需气管插管进行更换有创通气的使用率和肺表面活性物质的使用率分别为40.0%（16/40）、62.5%（25/40），均高于NIPPV组17.5%（7/40）、32.5%（13/40），差异有统计学意义（P<0.05）。两组患儿无创呼吸支持时间及应用辅助呼吸机的总用氧时间比较差异无统计学意义（P>0.05）。两组患儿并发症发生率比较差异无统计学意义（P>0.05）。
结论
NIPPV与NCPAP比较在无创呼吸支持时间、总用氧时间、并发症无统计学差异，但能减少气管插管、使用肺表面活性物质使用率。

关键词: 新生儿呼吸窘迫综合征, 极低出生体重儿, 鼻塞式间歇正压通气, 鼻塞式持续气道正压, 早产儿

Abstract:
Objective
To compare respiratory support treatment parameters and complications of nasal intermittent pressure ventilation(NIPPV) with nasal continuous positive airway pressure(NCPAP) in very-low-birth-weight(VLBW) preterm infants.
Methods
Totally 80 cases of VLBW premature infants were treated in the Second People's Hospital of Shantou from January 2015 to June 2016. They were included as the subjects and were randomly divided into two groups: NIPPV group and group B, each group having 40 cases. Non-invasive respiratory support time, total time with oxygen, 72h domestic replacement use of tracheal intubation and invasive ventilation, pulmonary surfactant use and complications were observed and recorded in detail.
Results
The rate of 72h domestic replacement use of tracheal intubation and invasive ventilation and the rate of pulmonary surfactant use in NCPAP group were 40% (16/40) and 62.5% (25/40, 17.5%), which were higher than that of NIPPV group［(17.5%,7/40) and (32.5%,13/40)］, the difference being statistically significant (P<0.05). There was no significant difference between the two groups in the time of non-invasive respiratory support and the total oxygen use time with the auxiliary ventilator(P>0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).
Conclusion
Compared with NCPAP, NIPPV has no significant difference in non-invasive respiratory support time, total oxygen use time and complications, but it can reduce the use of tracheal intubation and use of pulmonary surfactant.

Key words: Neonatal respiratory distress syndrome, Very-low-birth-weight infant, Nasal intermittent positive pressure ventilation, Nasal continuous positive airway pressure, Preterm infant