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目的探讨双水平正压通气(BiPAP)联合肺表面活性物质(PS)治疗早产儿呼吸窘迫综合征(RDS)的临床疗效。方法 84例呼吸窘迫综合征早产儿随机分为实验组44例和对照组40例。两组均给予PS替代治疗,同时分别应用BiPAP及鼻塞持续正压通气(nCPAP),比较两组患儿经使用PS及无创呼吸支持后12、24、48 h血气分析结果、总用氧时间、气管插管发生情况。结果实验组经PS及BiPAP无创呼吸支持后12、24 h PaCO2低于对照组,PaO2在12、24、48 h均高于对照组,实验组气管插管6例(13.6%)少于对照组9例(22.5%),差异均有统计学意义(P<0.05)。结论使用BiPAP联合PS能更好的改善患儿肺的氧合功能,减少有创呼吸支持发生率,对改善RDS早产儿的生存质量及预后具有积极意义,值得进一步研究推广。
Objective To investigate the clinical effect of bi-level positive pressure ventilation (BiPAP) and pulmonary surfactant (PS) on respiratory distress syndrome (RDS) in preterm infants. Methods 84 cases of respiratory distress syndrome were randomly divided into experimental group 44 cases and control group 40 cases. Both groups were given PS replacement therapy, while the application of BiPAP and nasal continuous positive airway pressure (nCPAP) were compared between the two groups by PS and noninvasive respiratory support after 12,24,48 h blood gas analysis results, total oxygen time, Tracheal intubation occurs. Results PaCO2 in experimental group was lower than that in control group at 12 and 24 h after PS and BiPAP noninvasive respiratory support, PaO2 was higher at 12, 24 and 48 h than that in control group. Six patients (13.6%) in experimental group had less tracheal intubation than those in control group 9 cases (22.5%), the difference was statistically significant (P <0.05). Conclusions The use of BiPAP combined with PS can better improve lung oxygenation and reduce the incidence of invasive respiratory support. It is of great significance to improve the quality of life and prognosis of premature infants with RDS. It is worth further study and promotion.