无创正压通气与同步间歇指令通气治疗早产儿呼吸窘迫综合征的疗效比较*

Comparison of efficacy of NIPPV ventilation and SIMV in the treatment of premature respiratory distress syndrome*

摘要:

目的 比较无创正压通气（NIPPV）与同步间歇指令通气（SIMV）治疗早产儿呼吸窘迫综合征（NRDS）的疗效。方法 选取2017年1月—2018年6月桂林医学院附属医院NRDS早产儿80例，采用随机数字表法将患儿分为对照组和观察组，每组40例。对照组患儿给予SIMV模式治疗，观察组患儿给予NIPPV模式治疗。比较两组血气分析指标、呼吸机参数、治疗时间及并发症发生率。结果 治疗0、24和48?h时，观察组各指标与对照组比较，差异有统计学意义（P?<0.05），观察组在24和48 h血氧分压（PaO2）、动脉血氧饱和度（SaO2）、氧指数（OI）水平高于对照组，动脉血二氧化碳分压（PaCO2）、吸入氧浓度（FiO2）低于对照组。观察组氧疗时间、呼吸机使用时间及住院时间与对照组比较，差异有统计学意义（P?<0.05），观察组短于对照组。治疗期间两组患者均出现呼吸机相关性肺炎、颅脑出血、肺出血等并发症，且两组并发症发生率差异无统计学意义（P?>0.05）。结论 相对SIMV有创通气模式，NIPPV通气疗法对ARDS患儿通气、氧合状态的改善程度及治疗时间优势更为明显，且安全可靠。

Abstract:

Objective To compare the efficacy of NIPPV ventilation and SIMV in the treatment of premature respiratory distress syndrome. Methods From January 2017 to June 2018, 80 premature infants with RDS were randomly divided into control group (n?=?40) and observation group (n?=?40). Children in the control group were treated with SIMV mode, and those in the observation group were treated with NIPPV mode. The blood gas analysis index, ventilator parameters, treatment time and complication rate were compared between the two groups. Results At 24?h and 48?h of the treatment, PaO2 (partial pressure of oxygen), SaO2 (arterial oxygen saturation) and OI (oxygen index) in observation group were significantly higher than that in control group, and PaCO2 (partial pressure of carbon dioxide in artery) and FiO2 were significantly lower than that in the control group. The time of oxygen therapy, the time of using ventilator and the time of hospitalization in the observation group were significantly lower than those in the control group (P??0.05). Conculsions Compared with the invasive ventilation mode of SIMV, NIPPV ventilation therapy was more safe and reliable in improving the degree of oxygenation and time of treatment in children with ARDS.