经鼻双水平和持续气道正压通气治疗极低体质量早产儿呼吸暂停的疗效比较  

Comparison of therapeutic effect of nBiPAP and nCPAP in the treatment of apnea of very low weight premature infants

作　　者：熊丽[1] 张连红[1] 孙婷[1] 

机构地区：[1]天门市第一人民医院新生儿科,湖北天门431700

出　　处：《安徽医药》2017年第9期1616-1618,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨经鼻双水平正压通气(nBiPAP)应用于极低体质量早产儿呼吸暂停(AOP)的疗效及安全性。方法选取86例极低体质量早产儿为研究对象,按随机数字表法将患儿分为经鼻持续气道正压通气(nCPAP)组和nBiPAP组,每组43例。观察患儿经治疗后的呼吸缓解情况及并发症,包括颅内出血、气胸、鼻压伤,同时比较各组的气管插管率、用氧时间、住院时间。结果 nBiPAP组呼吸暂停缓解率为53.49%,高于nCPAP组的30.23%,差异有统计学意义(χ~2=4.778,P=0.029)。总用氧时间、住院时间及气管插管率两组间比较差异无统计学意义(P>0.05)。nBiPAP组的颅内出血、支气管肺发育不良(BPD)及气胸发生率略低于nCPAP组,而鼻压伤发生率略高于nCPAP组,差异无统计学意义(P>0.05)。结论 nBiPAP在治疗极低体质量AOP时具有更好的临床疗效,且安全性相当,治疗上可优先考虑。Objective To investigate the efficacy and safety of nasal bi level positive pressure ventilation （nBiPAP） in the treatment of apnea （AOP） in very low birth weight premature infants. Methods Eighty-six cases of very low birth weight premature infants in de-partment of neonatology, the first peopled hospital of tianmen city were selected as the study subjects. The patients were randomly as-signed into nasal continuous positive airway pressure （nCPAP） group and nBiPAP group,each of 43 cases. After treatment,the respira-tory failure remission and complications were observed,including intracranial hemorrhage,pneumothorax,nasal pressure injury,and the tracheal intubation rate,oxygen time,hospitalization time of the patients were compared between the two groups. Results In nBiPAP group the apnea remission rate was 53.49% ,higher than 30. 23% in nCPAP group; the difference was statistically significant （ x2 - 4.778,P =0. 029）. Total oxygen time,hospital stay and tracheal intubation rate were not significantly different between the two groups （P 〉0. 05） . In nBiPAP group,the incidence rates of intracranial hemorrhage,BPD and pneumothorax were slightly lower than those of nCPAP group,but the incidence rate of nasal crush injury in nBiPAP group was slightly higher than that of nCPAP group; the difference was not statistically significant （P 〉0. 05） . Conclusions nBiPAP has better clinical efficacy in the treatment of very low body weight AOP,which is as safe as nCPAP,so it can be given priority in the treatment of very low body weight AOP.

关 键 词：早产 极低体质量 呼吸暂停 正压通气 双水平正压通气 

分 类 号：R722.6[医药卫生—儿科]