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目的比较经鼻间歇正压通气(NIPPV)与经鼻持续气道正压通气(NCPAP)在新生儿呼吸窘迫综合征(RDS)中的疗效。方法选择本院新生儿重症监护病房2010年6月至2012年7月收治的RDS患儿,随机分为NIPPV组和NCPAP组,比较两组治疗成功率、血气变化、应用NIPPV和NCPAP时间、并发症、两组治疗后需气管插管机械通气的比例及预后。结果两组患儿基本情况和RDS分级差异无统计学意义(P均>0.05)。NIPPV组(48例)治疗成功44例(91.7%),NCPAP组(50例)治疗成功38例(76.0%),两组差异有统计学意义(P<0.05)。NIPPV组治疗后1、12h的pH值、PaCO2、PaO2比NCPAP组改善更明显,两组比较差异有统计学意义(P<0.01)。NIPPV组治疗时间短于NCPAP组,NIPPV组需气管插管机械通气的比例低于NCPAP组,差异有统计学意义(P<0.01),部分NCPAP治疗失败病例(5/12)改为NIPPV治疗取得成功。结论 NIPPV治疗RDS疗效优于NCPAP。
Objective To compare the efficacy of nasal intermittent positive pressure ventilation (NIPPV) and nasal continuous positive airway pressure (NCPAP) in neonatal respiratory distress syndrome (RDS). Methods The RDS children admitted to our Neonatal Intensive Care Unit from June 2010 to July 2012 were randomly divided into NIPPV group and NCPAP group. The treatment success rate, blood gas change, NIPPV and NCPAP time were compared between the two groups Symptoms, the ratio and prognosis of mechanical ventilation of tracheal intubation after treatment in both groups. Results There was no significant difference between the two groups in the basic situation and RDS grading (all P> 0.05). In the NIPPV group (48 cases), 44 cases (91.7%) were successfully treated, and 38 cases (76.0%) were successfully treated in the NCPAP group (50 cases). There was significant difference between the two groups (P <0.05). After 1 and 12 hours of treatment, the PaCO2 and PaO2 of NIPPV group improved more obviously than that of NCPAP group, the difference was statistically significant (P <0.01). NIPPV group had shorter duration of treatment than NCPAP group, NIPPV group had lower rate of endotracheal intubation mechanical ventilation than NCPAP group, the difference was statistically significant (P <0.01), partial NCPAP treatment failure cases (5/12) was replaced by NIPPV treatment success. Conclusion NIPPV is superior to NCPAP in the treatment of RDS.