俯卧位经鼻双水平正压通气模式(DuoPAP)在早产儿反复呼吸暂停的应用  

Application of the Prone Position Nasal Dual Level Positive Pressure Ventilation Mode(DuoPAP)in Premature Infants with Recurrent Apnea

作　　者：廖沛娜 林多华[1] 孙世兰[1] 严美洁 熊凤霞 Liao Peina(Gaoming District People’s Hospital of Foshan City,Foshan 528500)

机构地区：[1]佛山市高明区人民医院,广东佛山528500

出　　处：《黑龙江医药》2023年第5期1017-1020,共4页Heilongjiang Medicine journal

基　　金：佛山市卫生健康局医学科研课题(编号:20210016)。

摘　　要：目的:探讨早产儿反复呼吸暂停应用俯卧位经鼻双水平正压通气模式(DuoPAP)的效果。方法:选择60例早产儿反复呼吸暂停且伴有低出生体重患儿研究,均为我院NICU收治,于2021年1月—2023年4月入组。随机数字法分为两组,每组30例,包括nCPAP组[常规治疗+俯卧位经鼻持续气道正压通气(nCPAP)]与DuoPAP组(常规治疗+俯卧位经鼻双水平正压通气DuoPAP),对比效果。结果:DuoPAP组总有效率明显高于nCPAP组(P<0.05);两组治疗后心率、呼吸、血压、SpO_(2)、FiO_(2)、PEEP无显著差异(P>0.05),但DuoPAP组PaO_(2)更高,PaO_(2)/FiO_(2)更高,PaCO_(2)更低,与nCPAP组差异显著(P<0.05);DuoPAP组无创通气时间与住院时间更少,而无创通气失败需有创通气的百分比更低,与nCPAP组差异显著(P<0.05);两组并发症比较,无显著差异(P>0.05)。结论:早产儿反复呼吸暂停采取俯卧位经鼻DuoPAP治疗,与俯卧位nCPAP比较,可更好地改善患儿的血气分析指标,减少CO_(2)潴留,避免再次插管有创通气治疗,同时还可缩短无创通气时间与住院时间,提高临床疗效,值得在NICU中应用。Objective:To explore the effect of using the prone position nasal dual level positive pressure ventilation mode(DuoPAP)in premature infants with recurrent apnea.Method:A study was conducted on 60 premature infants with recurrent apnea and low birth weight,all of whom were admitted to our NICU and enrolled from January 2021 to April 2023.Randomly divide into two groups with 30 cases in each group,including the nCPAP group(conventional treatment+prone position nasal continuous positive airway pressure(nCPAP))and the DuoPAP group(conventional treatment+prone position nasal dual level positive airway pressure ventilation DuoPAP),and compare the effects.Result:The total effective rate of DuoPAP group was significantly higher than that of nCPAP group(P<0.05);There was no significant difference in heart rate,respiration,blood pressure,SpO_(2),FiO_(2),and PEEP between the two groups after treatment(P>0.05),but the DuoPAP group had higher PaO_(2),higher PaO_(2)/FiO_(2),and lower PaCO_(2),which was significantly different from the nCPAP group(P<0.05);The DuoPAP group had less non-invasive ventilation time and hospital stay,while the percentage of non-invasive ventilation failures requiring invasive ventilation was lower,which was significantly different from the nCPAP group(P<0.05);There was no significant difference in complications between the two groups(P>0.05).Conclusion:Compared with prone position nCPAP,prone position DuoPAP can better improve the blood gas analysis index of premature infants with repeated apnea,reduce CO_(2) retention,avoid re intubation of invasive ventilation treatment,shorten the time of noninvasive ventilation and hospital stay,and improve the clinical efficacy.It is worth applying in NICU.

关 键 词：早产儿反复呼吸暂停 俯卧位 经鼻双水平正压通气模式 经鼻持续气道正压通气 血气分析 

分 类 号：R722.6[医药卫生—儿科]