早产儿呼吸窘迫综合征拔管后NIPPV和NCPAP作为无创呼吸支持过渡的临床效果对比  

Comparison of the clinical effects of NIPPV and NCPAP as a noninvasive respiratory support for preterm infants after extubation

作　　者：吴国豪 吴贞德 陈栋才 康健泉 林家叶 WU Guohao;WU Zhende;CHEN Dongcai;KANG Jianquan;LIN Jiaye(Wuchuan Maternal and Child Health and Family Planning Service Center,Wuchuan 524500,China)

机构地区：[1]吴川市妇幼保健计划生育服务中心,广东吴川524500

出　　处：《广州医药》2025年第4期516-522,共7页Guangzhou Medical Journal

基　　金：湛江市科技计划项目(2021B01020)。

摘　　要：目的探究经鼻间歇正压通气(NIPPV)和经鼻持续正压通气(NCPAP)作为早产儿呼吸窘迫综合征气管插管机械通气拔管后无创呼吸支持过渡的临床效果的差异。方法纳入2021年1月—2023年6月在广东省吴川市妇幼保健计划生育服务中心治疗的新生儿呼吸窘迫综合征早产儿66例,用随机数字表法将患儿分为NIPPV组(33例)和NCPAP组(33例)。NIPPV组患儿予经鼻间歇正压通气作为过渡期无创呼吸支持,NCPAP组患儿则予以经鼻持续正压通气作为过渡期无创呼吸支持。对比两组患儿治疗前后血气分析结果、脱机失败率、无创呼吸支持时间、无创后吸氧时间、总给氧时间等指标。结果接受无创呼吸支持12 h后,NIPPV组患儿的PaO_(2)升至(76.46±1.10)mmHg,高于NCPAP组患儿的(75.51±2.15)mmHg(t=2.249,P=0.028)。此外,NIPPV组患儿的SaO_(2)升至(96.36±0.52)%,也高于NCPAP组患儿的(96.07±0.59)%(t=2.138,P=0.034)。而NIPPV组患儿的PaCO_(2)则降至(41.39±0.74)mmHg,较NCPAP组患儿的(41.87±0.95)mmHg低(t=-2.230,P=0.025)。NIPPV组无创呼吸支持时间为(3.09±0.52)d,短于NCPAP组的(3.45±0.62)d,且该差异有统计学意义(t=2.584,P=0.012)。同样的,NIPPV组总给氧时间(9.52±0.76)天较NCPAP组的(10.00±0.79)天短,且该差异有统计学意义(t=-2.548,P=0.013)。而两组在脱机失败率、无创呼吸支持后吸氧时间、不良反应发生率等方面比较差异无统计学意义(均P>0.05)。结论与NCPAP模式相比,早产儿拔管后应用NIPPV模式进行无创呼吸支持取得的临床效果更优。Objective To explore the difference of clinical effect of nasal intermittent positive pressure ventilation(NIPPV)and nasal continuous positive pressure ventilation(NCPAP)as non-invasive respiratory support mode after extubation in preterm infants with endotracheal intubation.Methods Sixty-six cases of preterm infants with neonatal respiratory distress syndrome treated in our hospital from January 2021 to June 2023 were included.All the subjects were randomly divided into NIPPV group(n=33)and NCPAP group(n=33).The blood gas analysis results,weaning failure rate,non-invasive respiratory support time,oxygen inhalation time after noninvasive ventilation,total oxygen administration time.were compared between the two groups.Results After 12 hours of noninvasive respiratory support,PaO_(2)in the NIPPV group increased to(76.46±1.10)mmHg,which was significantly higher than that(75.51±2.15)mmHg in the NCPAP group(t=2.249,P=0.028).In addition,SaO_(2)in the NIPPV group increased to(96.36±0.52)%,which was also significantly higher than that(96.07±0.59)%in the NCPAP group(t=2.138,P=0.034).The PaCO_(2)in the NIPPV group decreased to(41.39±0.74)mmHg,which was lower than that(41.87±0.95)mmHg in the NCPAP group(t=-2.230,P=0.025).The duration of non-invasive respiratory support in the NIPPV group(3.09±0.52)days was shorter than that(3.45±0.62)days in the NCPAP group,and the difference was statistically significant(t=2.584,P=0.012).Similarly,the total duration of oxygen administration in the NIPPV group(9.52±0.76)days was shorter than that(10.00±0.79)days in the NCPAP group,and the difference was statistically significant(t=-2.548,P=0.013).There were no significant differences in weaning failure rate,oxygen inhalation time after noninvasive respiratory support,and incidence of adverse reactions between the two groups(P>0.05).Conclusions Compared with NCPAP mode,NIPPV mode for non-invasive respiratory support in preterm infants after extubating has better clinical effect,and it is worthy of clinical application.

关 键 词：早产儿 经鼻间歇正压通气 经鼻持续正压通气 临床效果 

分 类 号：R722.6[医药卫生—儿科]