鼻塞式同步间歇指令通气和持续气道正压通气在早产儿呼吸窘迫综合征中的应用比较

Randomized trail of nasal synchronized intermittent mandatory ventilation compared with nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome

摘要:

目的：比较鼻塞式同步间歇指令通气(nSIMV)和鼻塞式持续气道正压通气（nCPAP）在早产儿呼吸窘迫综合征（RDS）中的临床应用效果。方法：50例RDS早产儿,常规使用肺表面活性物质进行替代治疗后，随机分入nSIMV组或nCPAP组，观察治疗后临床症状和血气指标的变化。结果：nSIMV组需气管插管行呼吸机通气比率明显低于nCPAP组（24% vs 60%, P<0.05）；nSIMV组CO2潴留和低氧血症的比率分别为12%和24%，明显低于nCPAP组的40%和36%（P<0.05）。结论：nSIMV能更有效地对RDS早产儿进行呼吸支持治疗。［中国当代儿科杂志，2010，12（7）：524-526］

Abstract:

OBJECTIVE: To compare the efficacy of nasal synchronized intermittent mandatory ventilation (nSIMV) and nasal continuous positive airway pressure (nCPAP) in preterm infants with respiratory distress syndrome (RDS). METHODS: Fifty preterm infants with RDS who received pulmonary surfactant were randomized to nSIMV and nCPAP groups after extubation. Clinical signs, symptoms and blood gas results following nSIMV or nCPAP were compared in the two groups. RESULTS: Compared with the nCPAP group, the nSIMV group had a lower incidence of failure respiratory support (24% vs 60%; P<0.05), a lower incidence of hypercarbonia (12% vs 40%; P<0.05) and a lower incidence of hypoxia (24% vs 36%; P<0.05). CONCLUSIONS: nSIMV is more effective in respiratory support in preterm infants with RDS.［Chin J Contemp Pediatr, 2010, 12 (7):524-526］