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目的:比较经鼻间歇正压通气(NIPPV)与机械通气(SIMV+PC模式)对新生儿呼吸窘迫综合征治疗情况。方法:将68例新生儿呼吸窘迫综合征患者随机分为观察组(NIPPV)和对照组(SIMV+PC模式),两组均给予常规支持对症治疗,并应用肺表面活性物质替代治疗。比较两组血气分析指标、氧合指数(OI)、并发症等情况。结果:经过24 h、48 h的监测,两组Pa O2、Sa O2、Pa CO2、Fi O2、OI均较治疗前有明显改善(P<0.05),两组同时间比较,上述指标不具有统计学差异(P>0.05)。观察组氧疗时间、呼吸机使用时间均较对照组短(P<0.05),两组住院时间比较无统计学差异(P>0.05)。观察组的呼吸机相关性肺炎和气漏发生率明显低于对照组(P<0.05)。观察组治愈率为91.43%(32/35),对照组治愈率为84.85%,两组治愈率比较不具有统计学差异(P>0.05)。结论:NIPPV与机械通气均能改善患儿的通气和氧合状态,与气管插管机械通气相比,可以降低VAP和气漏发生率,降低氧疗时间,缩短住院时间。
PURPOSE: To compare the treatment of neonatal respiratory distress syndrome with nasal intermittent positive pressure ventilation (NIPPV) and mechanical ventilation (SIMV + PC mode). Methods: Sixty-eight neonates with respiratory distress syndrome were randomly divided into observation group (NIPPV) and control group (SIMV + PC mode). Both groups were given conventional support symptomatic treatment and pulmonary surfactant replacement therapy. Blood gas analysis index, oxygenation index (OI), complications and so on were compared between the two groups. Results: After 24 h and 48 h of monitoring, PaO2, Sa O2, PaCO 2, Fi O 2 and OI in both groups were significantly improved compared with those before treatment (P <0.05). There was no statistical difference between the two groups Learning difference (P> 0.05). Oxygen therapy time and ventilator use time in the observation group were shorter than those in the control group (P <0.05). There was no significant difference in hospitalization time between the two groups (P> 0.05). The incidence of ventilator-associated pneumonia and air leak in the observation group was significantly lower than that in the control group (P <0.05). The cure rate of the observation group was 91.43% (32/35), while the cure rate of the control group was 84.85%. There was no significant difference between the two groups in the cure rate (P> 0.05). Conclusion: Both NIPPV and mechanical ventilation can improve ventilation and oxygenation in children. Compared with endotracheal intubation mechanical ventilation, NIPPV and mechanical ventilation can reduce the incidence of VAP and air leakage, reduce the oxygen therapy time and shorten the hospitalization time.