肺表面活性物质与NIPPV、HHFNC、NCPAP结合治疗新生儿呼吸窘迫综合征的临床疗效比较  

Comparison of the clinical efficacy of surfactant in combination with NIPPV,HHFNC and NCPAP in the treatment of neonatal respiratory distress syndrome

作　　者：崔智亮 敖丽云 宋中福 杨嘉琛 张俊 朱緖亮 Cui Zhiliang;Ao Liyun;Song Zhongfu;Yang Jiachen;Zhang Jun;Zhu Xuliang(Department of Pediatrics,Hengli Hospital,Guangdong,Dongguan 523460,China)

机构地区：[1]东莞市横沥医院儿科,广东东莞523460

出　　处：《青岛医药卫生》2024年第6期443-446,共4页Qingdao Medical Journal

基　　金：东莞市社会发展科技项目(20221800903332)。

摘　　要：目的 探讨肺表面活性物质(PS)与鼻式间歇正压通气(NIPPV)、加温湿化高流量经鼻导管正压通气(HHFNC)、鼻塞式持续气道正压通气(NCPAP)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法 选取2022年5月至2024年5月我院收治的90例NRDS早产儿为研究对象,按随机数字表法分为三组,各30例。NIPPV组予以NIPPV治疗,HHFNC组予以HHFNC治疗,NCPAP组予以NCPAP治疗。比较三组血气指标、氧疗情况、有创通气情况及并发症。结果 三组0h、48h时血气指标相比,无统计学差异(P>0.05);NIPPV组12h时PaO_(2)、PaO_(2)/FiO_(2)高于HHFNC组、NCPAP组,PaCO_(2)低于对照组,NIPPV组、HHFNC组24h时PaO_(2)、PaO_(2)/FiO_(2)高于NCPAP组,PaCO_(2)低于NCPAP组,有统计学差异(P<0.05);NIPPV组氧疗时间、无创通气时间短于HHFNC组、NCPAP组,有统计学差异(P<0.05);NIPPV组、HHFNC组有创通气率、并发症发生率低于NCPAP组,有统计学差异(P<0.05)。结论 NIPPV治疗NRDS可更快改善NRDS患儿血气指标,缩短氧疗时间、无创通气时间,且可降低有创通气率,安全可靠。Objective To explore the clinical efficacy of pulmonary surfactant(PS)with intermittent positive nasal pressure ventilation(NIPPV),warmed and humidified high-flow positive nasal pressure ventilation(HHFNC)and nasal pronged continuous positive airway pressure(NCPAP)in the treatment of neonatal respiratory distress syndrome(NRDS).Methods A total of 90 preterm infants with NRDS curatived to our hospital from May 2022 to May 2024 were selected as the study subjects,and they were divided evenly into three groups according to the random number table method.The NIPPV group was treated with NIPPV,the HHFNC group was treated with HHFNC,and the NCPAP group was treated with NCPAP.Blood gas indexes,oxygen therapy,invasive ventilation and complications were compared between the three groups.Results There was no significant difference in blood gas indexes between the three groups at 0 h and 48 h(P>0.05),PaO_(2) and PaO_(2)/FiO_(2) in the NIPPV group were higher than those in the HHFNC group and NCPAP group at 12 h,PaCO_(2) was lower than that in the control group,PaO_(2) and PaO_(2)/FiO_(2) were higher and PaCO_(2) were lower in the NIPPV group and HHFNC group than those in the NCPAP group at 24 h(P<0.05).The duration of non-invasive ventilation was statistically shorter than that of the HHFNC group and the NCPAP group(P<0.05),and the rate of invasive ventilation and complications in the NIPPV group and HHFNC group were lower than those in the NCPAP group (P <0.05). Conclusion NIPPV treatment of NRDS can improve blood gas indexes faster, shorten the duration of oxygen therapy and non-invasive ventilation, and reduce the rate of invasive ventilation, which is safe and reliable.

关 键 词：新生儿呼吸窘迫综合征 肺表面活性物质 鼻式间歇正压通气 不同通气方式 血气指标 

分 类 号：R332.3[医药卫生—人体生理学]