经鼻双相正压通气治疗新生儿呼吸窘迫综合征的优势研究  

Study on the advantages of nasal bi-level positive airway pressure ventilaton in treatment of RDS

作　　者：周婷[1] 王军[2] 

机构地区：[1]徐州医学院附属淮安医院儿科,江苏淮安223002 [2]徐州医学院附属医院新生儿科,江苏徐州221003

出　　处：《临床和实验医学杂志》2014年第17期1465-1467,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察经鼻双相正压通气(N-BiPAP)治疗新生儿呼吸窘迫综合征(RDS)的临床疗效。方法 52例诊断为RDS的患儿随机分为N-BiPAP组和经鼻持续气道正压通气(NCPAP)组。两组均常规给予猪肺磷脂注射液,观察比较两组的血气分析、血浆脑利钠肽(BNP)水平、通气时间、氧疗时间、住院天数和住院费用。结果 N-BiPAP组上机后12 h及24 h PaO2、PaO2/FiO2高于NCPAP组,PaCO2低于NCPAP组,差异有统计学意义(P<0.05);上机后两组血浆脑利钠肽浓度均有所下降,且N-BiPAP组下降更明显,差异有统计学意义(P<0.05)。N-BiPAP组通气时间及氧疗时间短于NCPAP组,差异有统计学意义(P<0.05),两组住院时间、费用比较差异无统计学意义(P>0.05)。结论N-BiPAP治疗新生儿呼吸窘迫综合征较CPAP在疗效及保护心功能方面更显著。Objective To observe the efficacy of nasal dual phase positive pressure ventilation（ nasal bi-level positive airway pressure,N-BiPAP） as ventilation mode for initial treatment of neonatal RDS. Methods A total of 52 cases diagnosed as RDS were randomly divided into N-BiPAP group and NCPAP group. Patients in both groups were routinely given with lung phospholipid injection,blood gas analyses were observed and compared,plasma levels of brain natriuretic peptide（ BNP）,duration for ventilation and oxygen therapy,length of hospitalization stay and hospital costs were observed and compared. Results Patients in N-BiPAP group were kept on N-BiPAP machine for 12 h and 24 h,PaO2 and PaO2/FiO2 were higher than those of patients in NCPAP group,PaCO2 was lower than that of NCPAP group,and the difference was statistically significant（ P〈0. 05）. Plasma level of brain natriuretic peptide had been declined in both groups after taking ventilation with machine,but it decreased more significantly in N-BiPAP group,and the difference was statistically significant（ P〈0. 05）. The duration of ventilation and oxygen therapy in N-BiPAP group was shorter than that of NCPAP group,and the difference was statistically significant（ P〈0. 05）,but the difference in length of hospitalization stay and the cost was not statistically significant（ P〉0. 05）. Conclusion The application of N-BiPAP in treatment of NRDS has more advantages than CPAP in curative effect and protection of heart function.

关 键 词：新生儿 呼吸窘迫综合征 经鼻双相正压通气 脑利钠肽 

分 类 号：R722.1[医药卫生—儿科]