中国全科医学2018，Vol.21Issue(16)：1983-1988,6.DOI:10.3969/j.issn.1007-9572.2018.16.016
无创高频振荡通气和双水平正压通气在早产儿呼吸窘迫综合征中的临床应用效果比较研究
Comparative Study of Noninvasive High-frequency Oscillatory Ventilation and Bilevel Positive Airway Pressure Ventilation for Preterm Infants with Respiratory Distress Syndrome
摘要
Abstract
Objective To compare the efficacy of nasal noninvasive high-frequency oscillatory ventilation (NHFOV) and duo positive airway pressure ventilation(DuoPAP) for premature infants with respiratory distress syndrome (RDS). Methods From June 2016 to May 2017,we enrolled 65 preterm infants with RDS who received medical care from NICU, Xinxiang Central Hospital and divided them into NHFOV group(33 cases receiving NHFOV) and DuoPAP group (32 receiving DuoPAP) by a random number table.We compared both groups' baseline characteristics,arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2),and oxygenation index (OI) at 0,1,12,24,48,72 h after receiving respiratory support,incidence of apnea within 72 h after receiving respiratory support,rate of invasive respiratory support,duration of noninvasive respiratory support,total duration of oxygen inhalation,repeated use of poractant alfa injection,incidence of pulmonary air leak (PAL),bronchopulmonary dysplasia(BPD),neonatal necrotizing enterocolitis (NEC), periventricular leukomalacia (PVL) and mortality.Results Sex,birth weight,onset time of RDS,gestational age,maternal use of hormone before delivery,duration of using poractant alfa injection,prevalence of birth by cesarean section,and RDS classification did not differ significantly between the groups(P>0.05).Moreover,mean PaO2and OI were similar in both groups (P>0.05).However,significant differences between the groups were found in mean PaCO2(P<0.05).PaO2、PaCO2、OI differed at different time point( P<0.05).Treatment regimen and duration produced significant interaction effect on PaCO(2P<0.05), but not on PaO2and OI(P>0.05).The incidence of apnea was much lower in NHFOV group compared with DuoPAP group (P<0.05).In addition,both groups showed no significant differences in the rate of invasive respiratory support,duration of noninvasive respiratory support,total duration of oxygen inhalation,repeated use of poractant alfa injection and incidence of PAL,BPD,NEC,PVL and mortality(P>0.05).Conclusion Compared with DuoPAP,NHFOV is more safe and effective for initial treatment of preterm infants with RDS,for it can better reduce CO2retention and decrease the risk of having apnea without increasing the incidence of adverse events.关键词
呼吸窘迫综合征,新生儿/无创高频振荡通气/双水平正压通气/无创呼吸支持模式/治疗结果Key words
Respiratory distress syndrome,newborn/Noninvasive high frequency oscillatory ventilation/Duo positive airway pressure ventilation/Noninvasive respiratory support model/Treatment outcome分类
医药卫生引用本文复制引用
娄五斌,张卫星,员丽,张冰..无创高频振荡通气和双水平正压通气在早产儿呼吸窘迫综合征中的临床应用效果比较研究[J].中国全科医学,2018,21(16):1983-1988,6.基金项目
新乡市科技攻关计划项目(CXGG16052) （CXGG16052）
