雙水平氣道正壓通氣和經鼻持續正壓通氣治療足月兒呼吸窘迫綜合征的差異分析

杜佩珍+林多華+孫世蘭+廖沛娜+潘文中

【摘要】 目的：研究雙水平氣道正壓通氣（double-level positive airway pressure，DuoPAP）和經鼻持續正壓通氣（nasal contin-uous positive airway pressure，nCPAP）治療足月兒呼吸窘迫綜合征（Neonatal respiratory distress syndrome，NRDS）的差異，為NRDS的治療提供更好的方案。方法：選取2015年

4月-2016年12月在本院治療的足月兒RDS患兒50例，采取隨機對照分組法分為DouPAP組（n=25）和nCPAP組（n=25）。兩組患者均采用常規的NRDS治療方案，在此基礎上分別給予DuoPAP和nCPAP治療，記錄兩組患兒治療后24 h的二氧化碳分壓（PCO2）、血氧分壓（PO2）及血pH，與治療前的情況進行分析比較。分析記錄整個治療過程中的持續通氣時間及治療后24 h吸入氧濃度（FiO2）、通氣治療失敗的比例以及通氣后出現不良反應的比例情況。結果：兩組患者治療后24 h血pH、PO2、PCO2較治療前均明顯改善（P<0.05）；DouPAP組治療后24 h PO2明顯高于nCPAP組，PCO2明顯低于nCPAP組（P<0.05）；DouPAP組治療后24 h FiO2和持續通氣時間均低于nCPAP組（P<0.05）；DouPAP組治療后通氣失敗率明顯低于nCPAP組（P<0.05）；兩組不良反應發生率比較，差異無統計學意義（P>0.05）。結論：雙水平氣道正壓通氣對足月兒呼吸窘迫綜合征的治療效果明顯優于經鼻持續正壓通氣，且安全性較好，可以在臨床上推廣。

【關鍵詞】 足月兒； 呼吸窘迫綜合征； 正壓通氣

【Abstract】 Objective：To study the differences of double-level positive airway pressure （DuoPAP） and nasal continuous positive pressure ventilation （nCPAP） in the treatment of newborns respiratory distress syndrome，provide a good treatment for neonatal RDS treatment.Method：Selected 50 full-term infants with RDS into the hospital treatment from April 2015 to December 2016，randomized control grouping was divided into DouPAP group（n=25） and nCPAP group（n=25）.Two groups of patients were treated with conventional NRDS regimen，on this basis，respectively given DuoPAP and nCPAP treatment，recorded the partial pressure of carbon dioxide（PCO2），partial pressure of oxygen（PO2） and the pH of the blood after treatment for 24 h，and compared with the situation before treatment，analysis of the duration of ventilation，after 24 h inhalation oxygen concentration（FiO2）and the incidence of ventilation failure and adverse reactions after ventilation.Result：The pH，PO2 and PCO2 were significantly improved in the two groups after 24 h of treatment（P<0.05），the PO2 of DouPAP group after treatment with 24 h was significantly higher than that of nCPAP group，and the PCO2 was significantly lower than that of nCPAP group（P<0.05）.After treatment with 24 h，FiO2 and the duration of ventilation in the DouPAP group were lower than those in the nCPAP group（P<0.05）.The failure rate of ventilation after treatment in DouPAP group was lower than that in nCPAP group（P<0.05），there was no significant difference in adverse reactions between the two groups（P>0.05）.Conclusion：DouPAP in the treatment of neonatal RDS was significantly better than nCPAP，and the security is better than it too，it is worthy of clinical promotion.

【Key words】 Term infant； Respiratory distress syndrome； Positive pressure ventilationendprint