经鼻间歇指令通气与经鼻持续正压通气在早产儿撤机后的应用  

Application of nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure after ventilator weaning in preterm infants

作　　者：江云[1] JIANG Yun(Department of Neonatology,Jiujiang Maternal and Child Health Hospital,Jiangxi Province,Jiujiang332000,China)

机构地区：[1]江西省九江市妇幼保健院新生儿科,江西九江332000

出　　处：《中国当代医药》2020年第19期129-132,共4页China Modern Medicine

基　　金：江西省卫生计生委科技计划项目(20197172)。

摘　　要：目的探讨经鼻间歇指令通气(NIPPV)与经鼻持续正压通气(NCPAP)在早产儿撤机后的应用效果。方法选取2016年6月~2019年7月我院收治的50例早产儿为研究对象,采用随机数字表法分为对照组(n=25)与观察组(n=25)。对照组采用NCPAP,观察组采取NIPPV。治疗后,比较两组的治疗效果、血气分析指标、患儿恢复情况及近远期并发症发生率。结果两组拔管7 d内撤机失败情况、动脉二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、pH、住院总时间、双顶径(BPD)、早产婴儿视网膜病变(ROP)、颅内出血发生率比较,差异无统计学意义(P>0.05);治疗后,观察组无创通气使用时间、吸入氧浓度(FiO2)低于对照组,差异有统计学意义(P<0.05)。结论早产儿撤机后,采取NIPPV与NCPAP治疗均能改善患儿缺氧状态,治疗效果显著,但从患儿近远期并发症情况等综合考虑,临床应根据患儿具体情况选择合适通气方案,若患儿条件允许,可优先选择NIPPV,旨在提高患儿生存质量。Objective To explore the application effect of nasal intermittent positive pressure ventilation(NIPPV)and nasal continuous positive airway pressure(NCPAP)after ventilator weaning in preterm infants.Methods A total of 50 preterm infants admitted to our hospital from June 2016 to July 2019 were selected as research subjects.They were divided into control group(n=25)and an observation group(n=25)by random number table method.NCPAP was used in the control group and NIPPV was used in the observation group.After treatment,the treatment effect,indicators of blood gas analysis,recovery,and near-term and long-term complications of the two groups were compared.Results The incidence of ventilator weaning failure within 7 days after extubation,arterial carbon dioxide partial pressure(PaCO2),arterial partial pressure of oxygen(PaO2),pH,total hospital stay,biparietal diameter(BPD),retinopathy of prematurity(ROP),and the incidence of intracranial hemorrhage of the two groups had no significant differences(P>0.05).After treatment,the time of non-invasive ventilation and fraction of inspired oxygen(FiO2)in the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion After ventilator weaning of premature infants,both NIPPV and NCPAP treatment can alleviate the hypoxic state of the infants,and the effect is remarkable.However,taking factors like the short-term and long-term complications of the infants into consideration,ventilation scheme should be appropriately chosen according to the specific conditions of the infants in clinic.If the infants′condition allows,NIPPV can be preferentially selected to improve their quality of life.

关 键 词：早产儿 经鼻间歇指令通气 经鼻持续正压通气 并发症 

分 类 号：R722.6[医药卫生—儿科]