NIPPV、NCPAP对RDS早产儿肺泡表面活性物质用量及临床疗效的对比研究  

Comparative Study of NIPPV and NCPAP on the Dosage and Clinical Efficacy of Pulmonary Surfactant in Premature Infants with RDS

作　　者：黄栋钦 肖建佳 胡伟滨 蔡伟泽 林月云 HUANG Dongqin;XIAO Jianjia;HU Weibin;CAI Weize;LIN Yueyun(Department of Neonatology,Anxi County Hospital,Quanzhou,Fujian 362400,China)

机构地区：[1]安溪县医院新生儿科,福建泉州362400

出　　处：《中国医药指南》2025年第11期8-10,共3页Guide of China Medicine

基　　金：福建中医药大学校管临床专项资助(XB2022005)。

摘　　要：目的探究对呼吸窘迫综合征(RDS)早产儿应用经鼻间歇正压通气(NIPPV)和持续气道正压通气(NCPAP)治疗对肺泡表面活性物质(PS)用量及疗效的影响。方法选取2022年4月至2024年4月于安溪县医院新生儿科诊治的RDS早产儿50例,按照通气方式及倾向性匹配法将患儿分为NIPPV组(25例)与NCPAP组(25例)。NIPPV组予以NIPPV下外源性PS给药治疗,NCPAP组采取NCPAP下外源性PS给药治疗。比较两组患儿的PS用量、再次进行PS治疗例数、通气相关指标、血气分析指标以及并发症发生情况。结果两组患儿PS用量与再次进行PS治疗的例数对比,差异无统计学意义(P>0.05),NIPPV组患儿治疗后呼吸频率、撤机时间和总吸氧时间均少于NCPAP组(P<0.05)。治疗12 h、24 h、48 h时,NIPPV组PaO2、OI指标水平均高于NCPAP组(P<0.05)。两组患儿并发症总发生率对比,差异无统计学意义(P>0.05)。结论NIPPV和NCPAP两种治疗手段在早产儿呼吸窘迫综合征中均有良好效果及安全性,二者在PS用量方面几乎相同,而相较于NCPAP,NIPPV更能改善患儿的血氧水平,促进患儿的恢复。Objective To investigate the effects of nasal intermittent positive pressure ventilation(NIPPV)and continuous positive airway pressure ventilation(NCPAP)on the dosage and efficacy of pulmonary surfactant(PS)in premature infants with respiratory distress syndrome(RDS).Methods A total of 50 preterm infants with RDS treated in the neonatal department of Anxi County Hospital from April 2022 to May 2024 were divided into two groups based on ventilation methods and propensity score matching:the NIPPV group(25 cases)and the NCPAP group(25 cases).The NIPPV group received exogenous PS under NIPPV,while the NCPAP group received it under NCPAP.The study compared the two groups in terms of PS dosage,re-administration of PS,ventilation indicators,blood gas analysis,and complication incidence.Results There was no significant difference in PS usage or re-treatment cases between the two groups(P>0.05).However,the NIPPV group had lower respiratory rate,weaning time,and total oxygen inhalation time than the NCPAP group(P<0.05).At 12 hours,24 hours,and 48 hours,NIPPV groups’PaO2 and OI levels is higher than the NCPAP group(P<0.05).The total complication incidence was similar between the two groups(P>0.05).Conclusions Both NIPPV and NCPAP are effective and safe for treating respiratory distress syndrome in premature infants,with similar PS dosages.However,NIPPV is more effective than NCPAP in improving blood oxygen levels and promoting recovery.

关 键 词：呼吸窘迫综合征 早产儿 经鼻间歇正压通气 持续气道正压通气 肺表面活性物质 

分 类 号：R722.1[医药卫生—儿科]