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目的评价经鼻持续正压通气(NCPAP)与常规机械通气(CMV)对新生儿肺透明膜病(HMD)的治疗效果和NCPAP是否降低呼吸机相关肺炎(VAP),呼吸机所致肺损伤(VILI)等发生。方法 对38例在我院新生儿科住院的HMD患儿进行临床观察,随机分为两组,NCPAP组18例,CMV组20例。所有38例患儿均在生后24小时内给予单剂猪肺表面活性物质(固尔苏120 mg／kg)。NCPAP组应用INFANTFLOW SYSTEM(英国EME公司产)呼吸机。CMV组应用VIP BIRD(美国产)呼吸机IPPV+PEEP。辅助呼吸。结果 存活:NCPAP组16／18例,CMV组成活17／20例,两组在存活率、用机时间、颅内出血上无显著差异,而在呼吸机相关性肺炎、呼吸机致肺损伤并发症上,NCPAP组明显低于CMV组,经X2检验两组差异有显著,P<0.05。结论NCPAP可有效地治疗新生儿HMD,并可明显减少VAP和VILI的发生。
Objective To evaluate the effect of NCPAP and CMV on neonatal hyaline membrane disease (HMD) and whether NCPAP reduces ventilator-associated pneumonia (VAP), ventilator-induced lung injury VILI) and so on. Methods 38 cases of HMD hospitalized in neonates in our hospital were randomly divided into two groups: 18 cases in NCPAP group and 20 cases in CMV group. All 38 infants were given a single dose of porcine pulmonary surfactant (Cortisol 120 mg / kg) within 24 hours of birth. NCPAP group using INFANTFLOW SYSTEM (British EME company production) ventilator. The CMV group used VIP BIRD (US-made) ventilator IPPV + PEEP. Assist breathing. Results Survival: There were 16/18 cases in NCPAP group and 17/20 cases in CMV group. There was no significant difference in survival rate, machine time and intracranial hemorrhage between the two groups. However, in ventilator-associated pneumonia, complications of ventilator-induced lung injury On the other hand, the NCPAP group was significantly lower than the CMV group, the difference was significant (P <0.05) by the X2 test. Conclusion NCPAP can effectively treat neonatal HMD, and can significantly reduce the occurrence of VAP and VILI.