摘要
目的分析新生儿呼吸窘迫综合征(NRDS)疾病特点,评价经鼻间歇气道正压通气(NIPPV)联合咖啡因对患儿撤离有创呼吸机后的治疗效果。方法80例NRDS患儿,随机分为对照组与观察组,各40例。撤机后对照组新生儿采取经鼻持续气道正压通气(NCPAP)+咖啡因治疗,观察组新生儿采取NIPPV+咖啡因治疗。比较两组并发症发生情况、结局、撤机后血气指标。结果两组支气管肺发育不良(BPD)发生率、坏死性小肠结肠炎(NEC)发生率、早产儿视网膜病(ROP)发生率、重新上机率、病死率比较,差异无统计学意义(P>0.05)。撤机1、12 h后,观察组的动脉血二氧化碳分压(PaCO2)分别为(45.01±3.30)、(45.88±2.50)mm Hg(1 mm Hg=0.133 kPa),低于对照组的(50.22±4.50)、(58.01±3.05)mm Hg,动脉血氧分压(PaO2)分别为(68.01±1.60)、(72.02±1.20)mm Hg,高于对照组的(52.01±1.33)、(69.80±1.03)mm Hg,差异有统计学意义(P<0.05)。两组pH比较差异无统计学意义(P>0.05)。结论与NCPAP+咖啡因治疗比较,NIPPV+咖啡因用于NRDS呼吸机辅助通气患儿撤机,有助于改善患儿的血气氧合指标,安全性方面理想。
Objective To analyze the characteristics of neonatal respiratory distress syndrome(NRDS)and evaluate the therapeutic effect of nasal intermittent positive pressure ventilation(NIPPV)combined with caffeine after weaning from invasive ventilator.Methods A total of 80 children with NRDS were randomly divided into control group and observation group,with 40 cases in each group.After weaning,the control group was treated with nasal continuous positive airway pressure(NCPAP)and caffeine,and the observation group was treated with NIPPV combined with caffeine.The occurrence of complications,outcomes,and blood gas indicators after weaning were compared between the two groups.Results The difference in the incidence of bronchopulmonary dysplasia(BPD),necrotizing enterocolitis(NEC),retinopathy of prematurity(ROP),re-ventilation rate,and fatality rate between the two groups were not statistically significant(P>0.05).1 and 12 h after weaning,the arterial partial pressure of carbon dioxide(PaCO2)in the observation group were(45.01±3.30)and(45.88±2.50)mm Hg(1 mm Hg=0.133 kPa),which were lower than(50.22±4.50)and(58.01±3.05)mm Hg in the control group,and the arterial partial pressure of oxygen(PaO2)were(68.01±1.60)and(72.02±1.20)mm Hg were higher than(52.01±1.33)and(69.80±1.03)mm Hg in the control group.All the difference was statistically significant(P<0.05).There was no statistically significant difference in pH between the two groups(P>0.05).Conclusion Compared with the treatment of NCPAP and caffeine,NIPPV combined with caffeine for weaning of NRDS children with ventilator-assisted ventilation is helpful to improve the blood gas oxygenation index,with ideal safety.
作者
潘廷辉
李旭
蒋劢
陈丹
丁俊东
PAN Ting-hui;LI Xu;JIANG Mai(Department of Neonatology,Fifth People’s Hospital,Zhuhai 519055,China)
出处
《中国实用医药》
2021年第27期35-37,共3页
China Practical Medicine
关键词
经鼻间歇气道正压通气
经鼻持续气道正压通气
咖啡因
新生儿呼吸窘迫综合征
撤机
并发症
Nasal continuous positive airway pressure
Nasal intermittent positive pressure ventilation
Caffeine
Neonatal respiratory distress syndrome
Weaning
Complications
