NIPPV联合LISA技术治疗NRDS效果及对早产儿动脉血气、不良事件发生的影响  

Effect of nasal intermittent positive pressure ventilation combined with less invasive surfactant administration for treating premature infants with neonatal respiratory distress syndrome and its influence on the arterial blood gas and incidences of advers events

作　　者：张原园 刘翠兰 ZHANG Yuanyuan;LIU Cuilan(Maternal and Child Health Care Hospital,Guang'an,Sichuan Province,638000;Guang'an Hospital of West China,Sichuan University,Guang'an)

机构地区：[1]四川省广安市妇幼保健院,638000 [2]四川大学华西广安医院

出　　处：《中国计划生育学杂志》2024年第7期1533-1537,共5页Chinese Journal of Family Planning

摘　　要：目的:探究经鼻间歇正压通气(NIPPV)联合微创注入肺表面活性物质治疗(LISA)技术治疗新生儿呼吸窘迫综合征(NRDS)效果及对早产儿动脉血气、不良事件发生率的影响分析。方法:选取2020年6月-2023年9月本院诊治的96例NRDS早产儿,简单随机分组法分为观察组和对照组各48例,两组均在新生儿重症监护病房实施无创辅助通气治疗,其中对照组行经鼻持续气道正压通气(NCPAP)+LISA技术治疗,观察组行NIPPV+LISA技术治疗,比较两组临床治疗情况、动脉血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SiO_(2))、PH]、指标、肺氧合指标[动脉血氧分压/肺泡氧分压(PaO_(2)/PAO_(2))、氧合指数(OI)]及不良事件发生率。结果:治疗后,观察组无创通气时间(5.3±1.7d)、有创通气占比(16.7%)、总氧疗时间(10.7±2.2d)、住院时间(27.9±4.3d)均低于对照组(6.6±2.0d、35.4%、12.4±2.5d、31.6±5.1d),撤机成功占比(87.5%)高于对照组(72.9%);两组PaO_(2)、SiO_(2)、PaO_(2)/PAO_(2)、PH值均升高,PaCO_(2)、OI水平均降低,且观察组改善幅度大于对照组;观察组总不良事件发生率(8.3%)低于对照组(25.0%)(均P<0.05)。结论:NIPPV联合LISA技术可更有效改善NRDS早产儿动脉血气,增强肺通气,促进临床症状改善,缩短住院时间。Objective:To explore the effect of nasal intermittent positive pressure ventilation(NIPPV) combined with less invasive surfactant administration(LISA) for treating premature infants with neonatal respiratory distress syndrome(NRDS),and to study its influence on the arterial blood gas and incidences of adverse events of the premature infants.Methods:From June 2020 to September 2023,96 prerature infants with NRDS were selected and were divided into observation group(48 cases) and control group(48 cases) according to the simple randomization grouping method.The infants in both groups were given non-invasive assisted ventilation in the neonatal intensive care unit.The infants in the control group received NCPAP treatment,while the infants in the observation group received NCPAP combined with LISA treatment.The clinical treatment status,the values of arterial blood gas indicators,such as arterial partial oxygen pressure(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),arterial oxygen saturation(SiO_(2)) and PH,the values of pulmonary oxygenation indexes,such as arterial partial oxygen pressure/partial alveolar oxygen pressure(PaO_(2)/PAO_(2)) and oxygenation index(OI),and the incidence of adverse events of the infants were compared between the two groups.Results:After treatment,the non-invasive ventilation time(5.3±1.7d),the proportion of invasive ventilation(16.7%),the total oxygen therapy time(10.7±2.2d),and the duration of hospital stay(27.9±4.3d) of the infants in the observation group were significantly lower than those(6.6±2.0d,35.4%,12.4±2.5d and 31.6±5.1d) of the infants in the control group.The successful rate of stopping ventilation(87.5%) of the infants in the observation group was significantly higher than that(72.9%) of the infants in the control group.The values of PaO_(2),SiO_(2),PaO_(2)/PAO_(2) and PH of the infants in the two groups after treatment had increased significantly,and the PaCO_(2) and OT values of the infants in the two groups after treatment had decreased significantly

关 键 词：早产儿 新生儿呼吸窘迫综合征 经鼻间歇正压通气 经细导管注入肺表面活性物质 动脉血气 

分 类 号：R722.6[医药卫生—儿科]