不同通气方式联合珂立苏治疗新生儿呼吸窘迫综合征疗效比较  

Efficacy of different ventilation modes combined with Calsurf in treatment of neonatal respiratory distress syndrome

作　　者：刘枭[1] 吴杰斌[1] 蒋腾 金宝[1] 周彬[1] Liu Xiao et al(Xuzhou Center Hospital Affiliated to Nanjing University of Chinese Medicine, Xuzhou 221009, China)

机构地区：[1]南京中医药大学附属徐州中心医院,江苏221009

出　　处：《齐齐哈尔医学院学报》2017年第14期1629-1631,共3页Journal of Qiqihar Medical University

摘　　要：目的研究不同通气方式联合珂立苏治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法选择2015年11月至2016年11月我院收治的64例NRDS患儿进行前瞻性研究,采用随机、双盲对照组法,将研究对象随机数字表达分为鼻塞间歇正压通气(SNIPPV)组和呼吸道正压通气(NCPAP)组各32例。SNIPPV组患儿采取同步联合珂立苏治疗,NCPAP组患儿采用NCPAP联合珂立苏治疗,比较两组患儿治疗前后血液酸碱度(p H)、氧分压(PO_2)、二氧化碳分压(PCO_2)、吸入氧浓度(FiO_2)水平变化,以及用机时间、氧疗时间、住院时间和并发症发生情况。结果治疗后,p H值、PO_2显著高于治疗前,PCO_2、FiO_2水平显著低于治疗前,且SNIPPV组患儿p H值、PO_2水平显著高于NCPAP组患儿,PCO_2、FiO_2水平显著低于NCPAP组患儿,差异有统计学意义(P<0.05)。SNIPPV组患儿用机时间、氧疗时间及住院时间均显著低于NCPAP组患儿,CO_2潴留率12.50%、腹胀率9.38%、重新气管插管发生率3.03%均显著低于NCPAP组患儿CO_2潴留率、腹胀率、重新气管插管发生率分别为34.38%、37.50%和25.00%,差异有统计学意义(P<0.05)。结论 SNIPPV与NCPAP临床作用相似,SNIPPV联合珂立苏能显著降低NRDS患儿气管插管行机械通气比例,临床疗效显著。Objective To study the clinical efficacy of different ventilation modes combined with Calsurf in the treatment of neonatal respiratory distress syndrome （NRDS）. Methods A total of 64 children with NRDS admitted to our hospital during November 2015 to November 2016 were prospectively studied. The subjects were divided into two groups by the randomized, double-blind and controlled method and random number table method, 32 cases in each group. Children treated by synchronized nasal intermittent positive pressure ventilation （SNIPPV） combined with Calsurf were included into SNIPPV group, while children treated by nasal continuous positive airway pressure （NCPAP） combined with Calsurf were included into NCPAP group. Changes of blood power of hydrogen （PH）, partial pressure of oxygen （ PO2 ）, partial pressure of carbon dioxide （PCO2） and inhaled oxygen concentration （FiO2 ） before and after treatment, the time of using machine, duration of oxygen therapy, length of hospital stay and incidence of complications were compared between the two groups. Results PH and PO2 were significantly higher in SNIPPV group than NCPAP group in 12h （P〈0.05）, while PCO2 and FiO2 were significantly lower （P〈0.05）. The time of using machine, duration of oxygen therapy and length of hospital stay of SNIPPV group were significantly shorter than those of NCPAP group （P〈0.05）. The incidence rates of CO2 retention, abdominal distension and re-intubation were significantly lower in SNIPPV group than NCPAP group （ 12.50%, 9.38% and 3.03% vs 34.38%, 37.50% and 21.88%） （P〈0.05）. Conclusions The clinical effects of SNIPPV and NCPAP are similar. SNIPPV combined with Calsurf can significantly reduce the ratio of children with NRDS undergoing mechanical ventilation at tracheal intubation. The clinical curative effect is better than that of NCPAP.

关 键 词：呼吸窘迫综合征 新生儿 间歇正压通气 珂立苏 

分 类 号：R722.12[医药卫生—儿科]