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目的比较经鼻间歇正压通气(nasal intermittent positive pressure ventilation,NIPPV)与经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)在新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)中的疗效。方法采用前瞻性随机对照研究的方法,将109例于2008年1月至2009年12月在大坪医院儿科NICU(neonatal intensive care unit)住院的NRDS患儿(男性69例,女性40例)分为NIPPV组(51例)与nCPAP组(58例),观察比较两种方法治疗的时间、治疗前后患儿动脉血气分析结果、氧合指数(oxygenase index,OI)、并发症、治疗后需气管插管行机械通气的比例及预后。结果治疗前两组血气分析、OI差异无显著性(P>0.05),NIPPV组治疗后1h动脉血pH值、p(O2)和OI显著高于nCPAP组(P<0.05)。NIPPV组治疗成功率显著高于nCPAP组(88.2%vs75.9%,P<0.05)。NIPPV组患儿的预后结局中治愈好转出院者显著高于nCPAP组(94.1%vs84.5%,P<0.05)。结论NIPPV可显著降低NRDS患儿气管插管行机械通气的比例,其临床疗效优于nCPAP。
Objective To compare the effects of nasal intermittent positive pressure ventilation (nIPPV) and nasal continuous positive airway pressure (nCPAP) on neonatal respiratory distress syndrome (NRDS) In the efficacy. Methods A total of 109 NRDS children (69 males and 40 females) were hospitalized in neonatal intensive care unit (NICU) from January 2008 to December 2009 in a prospective randomized controlled study NIPPV group (nCPAP group) and nCPAP group (n = 58). The duration of treatment, the results of arterial blood gas analysis, the oxygenase index (OI), complication, The ratio and prognosis of tube ventilation. Results There was no significant difference in OI between the two groups before treatment (P> 0.05). The arterial blood pH, p (O2) and OI of NIPPV group were significantly higher than those of nCPAP group 1 h after treatment (P <0.05). The success rate of treatment in NIPPV group was significantly higher than that in nCPAP group (88.2% vs 75.9%, P <0.05). In the NIPPV group, the prognosis and outcome of patients who were cured and discharged were significantly higher than those in the nCPAP group (94.1% vs84.5%, P <0.05). Conclusions NIPPV can significantly reduce the proportion of mechanical ventilation in tracheal intubation patients with NRDS, and its clinical curative effect is better than nCPAP.