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目的:探讨应用不同呼吸支持方法对新生儿呼吸窘迫综合征治疗效果并分析引起新生儿死亡的危险因素。方法:回顾性分析64例患呼吸窘迫综合征新生儿,其中行经鼻间歇正压通气患者(NIPPV)34例,经鼻持续性正压通气(NCPAP)患者30例,观察两组患儿血气分析指标变化、并发症发生率及转机械通气率,并分析引起新生儿死亡的主要危险因素。结果:(1)应用NIPPV患儿与应用NCPAP患儿血气分析对比:NIPPV组患儿治疗1 h、12 h后血pH值及PO2明显高于NCPAP组(P<0.05),PCO2及FiO2明显低于NCPAP组(P<0.05)。(2)两组患儿并发症发生率及转机械呼吸治疗率比较:NIPPV组患儿出现腹胀及转机械通气治疗率明显低于NCPAP组(P<0.05)。(3)新生儿死亡危险因素分析:出生体重及最高A-aDO2为新生儿死亡的独立危险因素,回归系数分别为0.003和0.011,OR值分别为0.992和1.073。结论:NIPPV对治疗新生儿呼吸窘迫效果更好,出生体重及最高A-aDO2为新生儿死亡的独立危险因素。
Objective: To explore the effect of different respiratory support on neonatal respiratory distress syndrome and to analyze the risk factors of neonatal death. Methods: A total of 64 neonates with respiratory distress syndrome were retrospectively analyzed. Among them, 34 patients underwent nasal intermittent positive pressure ventilation (NIPPV) and 30 patients underwent nasal continuous positive airway pressure (NCPAP). Blood gas analysis Index changes, the incidence of complications and mechanical ventilation rate, and analyze the main risk factors for neonatal death. Results: (1) Comparison of blood gas analysis between NIPPV children and NCPAP children: The blood pH value and PO2 of NIPPV group were significantly higher than that of NCPAP group (P <0.05) after treatment for 1 h and 12 h, PCO2 and FiO2 were significantly lower In the NCPAP group (P <0.05). (2) The incidence of complication and respiration rate of mechanical ventilation in two groups: The incidence of abdominal distension and mechanical ventilation in the NIPPV group was significantly lower than that in the NCPAP group (P <0.05). (3) Neonatal risk factors analysis: The birth weight and the highest A-aDO2 were independent risk factors for neonatal death. The regression coefficients were 0.003 and 0.011, respectively, with OR values of 0.992 and 1.073, respectively. CONCLUSIONS: NIPPV is more effective in treating neonatal respiratory distress, and birth weight and the highest A-aDO2 are independent risk factors for neonatal death.