CAJ | 학술논문

目的：探讨鼻塞式双水平正压通气( nasal Duo positive airway pressure ventilation, nDuoPAP)在早产儿肺透明膜病( hyaline membrane disease,HMD)呼吸机撤离中的临床应用。方法收集2013年1月至2014年6月徐州市中心医院NICU收治76例HMD(Ⅲ~Ⅳ级)机械通气早产儿,采用随机数字表法将患儿随机分为nDuoPAP组41例,鼻塞持续气道正压通气( nasal continuous positive air-way pressure,nCPAP)组35例,观察患儿撤机后pH值、PaCO2、PaO2、氧合指数以及撤机效果。结果nDuoPAP组撤机后1 h、24 h, PaCO2、PaO2、氧合指数与 nCPAP 组比较,差异均有统计学意义( P <0．05)。 nDuoPAP组与nCPAP组撤机失败率[5%(2/41) vs．26%(9/35)]以及呼吸暂停发生率[12%(5/41) vs．34%(12/35)]比较,差异均有统计学意义(P<0．05)；nDuoPAP组与nCPAP组无创通气时间[(2．88±1．37) d vs．(3．12±1．09) d]比较,差异无统计学意义(P>0．05)。结论 nDuoPAP用于HMD呼吸机的撤离,与nCPAP相比,可改善氧合,缓解二氧化碳潴留和减少呼吸暂停的发生。
목적：탐토비새식쌍수평정압통기( nasal Duo positive airway pressure ventilation, nDuoPAP)재조산인폐투명막병( hyaline membrane disease,HMD)호흡궤철리중적림상응용。방법수집2013년1월지2014년6월서주시중심의원NICU수치76례HMD(Ⅲ~Ⅳ급)궤계통기조산인,채용수궤수자표법장환인수궤분위nDuoPAP조41례,비새지속기도정압통기( nasal continuous positive air-way pressure,nCPAP)조35례,관찰환인철궤후pH치、PaCO2、PaO2、양합지수이급철궤효과。결과nDuoPAP조철궤후1 h、24 h, PaCO2、PaO2、양합지수여 nCPAP 조비교,차이균유통계학의의( P <0．05)。 nDuoPAP조여nCPAP조철궤실패솔[5%(2/41) vs．26%(9/35)]이급호흡잠정발생솔[12%(5/41) vs．34%(12/35)]비교,차이균유통계학의의(P<0．05)；nDuoPAP조여nCPAP조무창통기시간[(2．88±1．37) d vs．(3．12±1．09) d]비교,차이무통계학의의(P>0．05)。결론 nDuoPAP용우HMD호흡궤적철리,여nCPAP상비,가개선양합,완해이양화탄저류화감소호흡잠정적발생。
Objective To investigate the clinical application of nasal Duo positive airway pressure ventilation( nDuoPAP) in the treatment of ventilator withdrawal on hyaline membrane disease of preterm in-fants. Methods The total of 76 cases of preterm infants with hyaline membrane disease in NICU of Xuzhou Central Hospital from January 2013 to June 2014 were divided into two groups by random number table meth-od:nDuoPAP group(41 cases) and nasal continuous positive airway pressure(nCPAP) group(35 cases). The main observation consequences were compared with the pH value,PaCO2 ,PaO2 ,oxygenation index( OI) and the effect of weaning. Results The PaCO2 , PaO2 , OI at 1 h and 24 h after weaning between the two groups showed significant difference(P<0. 05). The weaning failure rate[5%(2/41) vs. 26%(9/35)] and the apnea rate[12%(5/41) vs. 34%(12/35)] between the two groups were significant difference(P <0. 05). The noninvasive ventilation time between the two groups showed no significant difference ( P >0. 05 ) . Conclusion nDuoPAP compared with nCPAP used in the weaning of mechanical ventilation can im-prove the oxygenation index and relieve carbon dioxide retention,and can reduce the incidence of apnea in preterm infants with hyaline membrane disease.