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目的:探讨在肺透明膜病(HMD)早产儿中应用同步鼻塞式持续正压通气(CPAP)呼吸机(NCPAP)的临床疗效。方法:选取2011年8月～2012年8月入住该院NICU确诊的HMD早产儿42例,按随机数字表分为观察组和对照组,每组21例,观察组给予肺表面活性物质(PS)+NCPAP治疗,对照组给予PS+有创机械通气(CMV)治疗,比较两组患儿治疗后效果。结果:两组患儿治疗前血气分析差异无统计学意义(P均>0.05)。治疗后1 h、12 h血气分析发现观察组优于对照组,观察组较对照组氧疗时间短(0.3±0.3)天,呼吸机相关性肺炎(VAP)发生率降低33.33%(7/21),呼吸机所致肺损伤(VI-LI)发生率降低33.33%(7/21),成功率高28.57%(6/21),经统计分析,差异均有统计学意义(P<0.05)。结论:NCPAP治疗HMD早产儿具有模仿生理呼吸同步性,氧耗减少,用氧时间缩短,治疗成功率明显提高,值得推广应用。
Objective: To investigate the clinical efficacy of synchronized nasal continuous positive airway pressure (CPAP) ventilator (NCPAP) in premature infants with hyaline membrane disease (HMD). Methods: From August 2011 to August 2012, 42 preterm infants with HMD confirmed by NICU in our hospital were divided into observation group and control group according to random number table, 21 cases in each group. The observation group received pulmonary surfactant (PS ) + NCPAP, while the control group received PS + invasive mechanical ventilation (CMV). The effect of treatment was compared between the two groups. Results: There was no significant difference in blood gas analysis between the two groups before treatment (P> 0.05). The blood gas analysis at 1 and 12 h after treatment showed that the observation group was superior to the control group. The oxygen therapy time in the observation group was shorter than that in the control group (0.3 ± 0.3 days) and the incidence of ventilator-associated pneumonia (VAP) was 33.33% (7/21) ), The incidence of ventilator-induced lung injury (VI-LI) was reduced by 33.33% (7/21), and the success rate was 28.57% (6/21) .Through statistical analysis, the differences were statistically significant (P0.05) . CONCLUSION: NCPAP treatment of preterm infants with HMD has simulated physiological respiration synchronization, reduced oxygen consumption, oxygen time shortened, the success rate was significantly improved, it is worth promoting the application.