临床儿科杂志
臨床兒科雜誌
림상인과잡지
2014年
8期
732-735
,共4页
双水平正压通气%持续气道正压通气%新生儿呼吸窘迫综合征%早产儿
雙水平正壓通氣%持續氣道正壓通氣%新生兒呼吸窘迫綜閤徵%早產兒
쌍수평정압통기%지속기도정압통기%신생인호흡군박종합정%조산인
duo positive airway pressure ventilation%continuous positive airway pressure%neonatal respiratory distress syndrome%preterm infant
目的：探讨无创双水平正压通气(DuoPAP)在早产儿呼吸窘迫综合征(NRDS)中的临床应用效果。方法选择2012年12月至2013年12月新生儿重症监护病房65例NRDS患儿，随机分为DuoPAP组34例，鼻塞式持续气道正压通气(nCPAP)组31例，采用气管插管-应用肺表面活性物质(PS)-拔出气管插管技术，监测呼吸支持后1、12、24及72 h的血气pH值、血氧分压(PaO2)、二氧化碳分压(PaCO2)及氧合指数(OI)；分别记录72 h两组呼吸暂停、肺气漏、重复应用PS及无创通气失败例数，并进行统计学分析。结果 DuoPAP组在无创呼吸支持后1、12、24 h的OI均高于nCPAP组，PaCO2值均低于nCPAP组，PaO2也在无创呼吸支持后1、12 h大于nCPAP组，差异均有统计学意义(P<0.01)。DuoPAP组72 h内无创通气失败、呼吸暂停发生率明显低于nCPAP组，差异均有统计学意义(P<0.05)；两组肺气漏、重复使用PS的差异无统计学意义(P均>0.05)。结论 DuoPAP治疗NRDS与nCPAP相比能更快改善氧合，减少CO2潴留，减少有创机械通气比例。
目的：探討無創雙水平正壓通氣(DuoPAP)在早產兒呼吸窘迫綜閤徵(NRDS)中的臨床應用效果。方法選擇2012年12月至2013年12月新生兒重癥鑑護病房65例NRDS患兒，隨機分為DuoPAP組34例，鼻塞式持續氣道正壓通氣(nCPAP)組31例，採用氣管插管-應用肺錶麵活性物質(PS)-拔齣氣管插管技術，鑑測呼吸支持後1、12、24及72 h的血氣pH值、血氧分壓(PaO2)、二氧化碳分壓(PaCO2)及氧閤指數(OI)；分彆記錄72 h兩組呼吸暫停、肺氣漏、重複應用PS及無創通氣失敗例數，併進行統計學分析。結果 DuoPAP組在無創呼吸支持後1、12、24 h的OI均高于nCPAP組，PaCO2值均低于nCPAP組，PaO2也在無創呼吸支持後1、12 h大于nCPAP組，差異均有統計學意義(P<0.01)。DuoPAP組72 h內無創通氣失敗、呼吸暫停髮生率明顯低于nCPAP組，差異均有統計學意義(P<0.05)；兩組肺氣漏、重複使用PS的差異無統計學意義(P均>0.05)。結論 DuoPAP治療NRDS與nCPAP相比能更快改善氧閤，減少CO2潴留，減少有創機械通氣比例。
목적：탐토무창쌍수평정압통기(DuoPAP)재조산인호흡군박종합정(NRDS)중적림상응용효과。방법선택2012년12월지2013년12월신생인중증감호병방65례NRDS환인，수궤분위DuoPAP조34례，비새식지속기도정압통기(nCPAP)조31례，채용기관삽관-응용폐표면활성물질(PS)-발출기관삽관기술，감측호흡지지후1、12、24급72 h적혈기pH치、혈양분압(PaO2)、이양화탄분압(PaCO2)급양합지수(OI)；분별기록72 h량조호흡잠정、폐기루、중복응용PS급무창통기실패례수，병진행통계학분석。결과 DuoPAP조재무창호흡지지후1、12、24 h적OI균고우nCPAP조，PaCO2치균저우nCPAP조，PaO2야재무창호흡지지후1、12 h대우nCPAP조，차이균유통계학의의(P<0.01)。DuoPAP조72 h내무창통기실패、호흡잠정발생솔명현저우nCPAP조，차이균유통계학의의(P<0.05)；량조폐기루、중복사용PS적차이무통계학의의(P균>0.05)。결론 DuoPAP치료NRDS여nCPAP상비능경쾌개선양합，감소CO2저류，감소유창궤계통기비례。
Objective To explore the efficacy of duo positive airway pressure ventilation in treating preterm infant with neonatal respiratory distress syndrome (RDS). Methods 65 preterm infants admitted to the neonatal intensive care unit from December 2012 to December 2013 were randomly divided into DuoPAP group (34 cases) or NCPAP (31 cases) group. Blood gas analysis(pH value, PaO2, PaCO2 and OI) at 1h, 12h, 24h, and 72h, and incidence of apnea, pulmonary air leak, repeated application of pulmonary surfactant and non-invasive ventilation failure at 72h in the two groups were measured and compared after using intubate surfactant extubate (INSURE). Results OI after non-invasive ventilation at 1h, 12h, and 24h was signiifcantly higherin DuoPAP group than that in NCPAP group P<0.01). PaCO2 after non-invasive ventilation at 1h, 12h, 24hand 72h was signiifcantly lower in DuoPAP group than that in NCPAP group (P<0.01). PaO2 after non-invasive ventilation at 1h and 12h was higher in DuoPAP group than that in NCPAP group, and there was signiifcant difference between the two groups (P<0.01). The incidence of non-invasive ventilation failure, apnea in 72h was lower in DuoPAP group than that in NCPAP group, and there was signiifcant difference between the two groups (P<0.05). Conclusions Compared with NCPAP, DuoPAP is more feasible for improving oxygenation, decreasing the need for mechanical ventilation in 72h in preterm infants with neonatal RDS.
