NIPPV与SIMV治疗早产儿NRDS的效果对比  

Comparative study of the effect of nasal intermittent positive pressure ventilation and synchronized intermittent mandatory ventilation for treating neonatal respiratory distress syndrome of premature infants

作　　者：夏可 王爱琳 潘靓 王丽 XIA Ke;WANG Ailin;PAN Liang;WANG Li(Western Theater General Hospital,Chengdu,Sichuan Province,610083)

机构地区：[1]西部战区总医院,成都610083

出　　处：《中国计划生育学杂志》2024年第9期2074-2078,共5页Chinese Journal of Family Planning

摘　　要：目的:探究经鼻间歇正压通气(NIPPV)与同步间歇指令通气(SIMV)治疗新生儿呼吸窘迫综合征(NRDS)早产儿的效果对比。方法:选取本院2021年6月-2023年6月收治的NRDS患儿102例,随机数字表法分为NIPPV组(n=51)和SIMV(n=51)组。比较治疗3 d后的临床疗效、临床相关指标,比较治疗前后血气指标[二氧化碳分压(PaCO_(2))、氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))]、炎症指标[白介素-6(IL-6)、高迁移率族蛋白-1(HMGB-1)、肿瘤坏死因子-α(TNF-α)、骨形态发生蛋白-7(BMP-7)]、呼吸力学指标[潮气量(VT)、肺动态顺应性(CD)、氧合指数(OI)]差异;记录治疗期间不良反应发生率。结果:治疗3 d后,NIPPV组临床疗效(88.2%)高于SIMV组(70.6%),呼吸机使用时间、氧疗时间、住院时间、呼吸暂停次数均低于SIMV组,两组PaCO_(2)、IL-6、HMGB-1、TNF-α、BMP-7水平均降低且NIPPV组低于SIMV组,两组PaO_(2)、SaO_(2)、VT、CD、OI水平均升高且NIPPV组高于SIMV组,不良反应发生率NIPPV组(11.8%)低于SIMV组(29.4%)(均P<0.05)。结论:NIPPV治疗NRDS早产儿疗效更佳,能显著改善患儿血气指标,增强呼吸功能,抑制炎症反应,减少并发症发生风险。Objective:To explore the comparative effect of nasal intermittent positive pressure ventilation(NIPPV)and synchronized intermittent mandatory ventilation(SIMV)for treating the premature infants with neonatal respiratory distress syndrome(NRDS).Methods:102 premature infants with NRDS were selected and were divided into group A(51 infants with NIPPV)and group B(51 infants with SIMV)by random number table method from June 2021 to June 2023.The clinical efficacy after 3 days of treatment,the clinical related indicators values,the values of blood gas indicators,such as partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2))and arterial oxygen saturation(SaO_(2)),the levels of inflammatory indicators,such as interleukin-6(IL-6),high mobility group protein-1(HMGB-1),tumor necrosis factor-α(TNF-α),and bone morphogenetic protein-7(BMP-7),and the values of respiratory mechanics indicators,such as tidal volume(VT),dynamic lung compliance(CD)and oxygenation index(OI),of the infants before and after treatment were compared between the two groups.The incidence of the adverse reactions of the infants in the two groups during treatment was recorded.Results:The clinical efficacy(88.2%)of the infants in group A after 3d of treatment was significantly higher than that(70.6%)of the infants in group B.The breathing machine use time,the oxygen cure time,the time of hospital stay,the apnea number of the infants in group A were significantly lower than those of the infants in group B.The PaCO_(2)value and the levels of IL-6,HMGB-1,TNF-αand BMP-7 of the infants in the two groups had decreased significantly,and which of the infants in group A were significantly lower than those of the infants in group B.The PaO_(2)and SaO_(2)values,and the VT,CD and OI levels of the infants in the two groups had increased significantly,and which of the infants in group A were significantly higher than those of the infants in group B.The incidence of adverse reactions(11.8%)of the infants in group A was significantly lower than

关 键 词：新生儿呼吸窘迫综合征 经鼻间歇正压通气 同步间歇指令通气 临床疗效 

分 类 号：R722.6[医药卫生—儿科]