[气泡式鼻塞持续气道正压通气与传统鼻塞持续气道正压通气对新生儿呼吸窘迫综合征早产儿呼吸支持的临床效果]
[Clinical effect of bubble nasal continuous positive airway pressure versus conventional nasal continuous positive airway pressure in respiratory support for preterm infants with neonatal respiratory distress syndrome].
作者信息
Shu Xian-Xiao, Chen Chao, Tang Jun, Wang Hua
机构信息
Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2018 Jun;20(6):433-437. doi: 10.7499/j.issn.1008-8830.2018.06.001.
OBJECTIVE
To study the clinical effect and safety of bubble nasal continuous positive airway pressure (BNCPAP) versus conventional nasal continuous positive airway pressure (nCPAP) in respiratory support for preterm infants with neonatal respiratory distress syndrome (NRDS).
METHODS
A retrospective analysis was performed for the clinical data of 130 preterm infants with NRDS. Among them, 69 underwent BNCPAP and 61 underwent nCPAP. The two groups were compared in terms of mortality rate, duration of respiratory support, use of pulmonary surfactant (PS), and treatment failure rate, and the incidence rates of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP), as well as the changes in blood gas pH, partial pressure of oxygen, and partial pressure of carbon dioxide. The safety was evaluated for both groups.
RESULTS
There were no significant differences between the BNCPAP group and the nCPAP group in sex distribution, gestational age, birth weight, Apgar score at 1 and 5 minutes after birth, delivery mode, and the severity of NRDS (P>0.05). No infants in the BNCPAP group died, and one infant in the nCPAP group died; there was no significant difference in the mortality rate between the two groups (P>0.05). There were also no significant differences between the two groups in the duration of noninvasive ventilation, treatment failure rate, the incidence rates of BPD and ROP, and the percentage of infants with a need for use or reuse of PS (P>0.05). After 8-12 hours of ventilation, there were no significant differences between the two groups in the changes in blood gas pH and oxygenation index (P>0.05), while the BNCPAP group had a significantly greater reduction in partial pressure of carbon dioxide than the nCPAP group (P<0.05). There were no significant differences between the two groups in the incidence rates of pneumothorax, nasal septal injury, and nasal mucosal injury (P>0.05).
CONCLUSIONS
BNCPAP and nCPAP have similar clinical effect and safety in respiratory support for preterm infants with NRDS.
目的
研究气泡式鼻塞持续气道正压通气（BNCPAP）与传统鼻塞持续气道正压通气（nCPAP）对新生儿呼吸窘迫综合征（NRDS）早产儿进行呼吸支持的临床效果及安全性。
方法
对130例NRDS早产儿的临床资料进行回顾性分析。其中，69例接受BNCPAP治疗，61例接受nCPAP治疗。比较两组的死亡率、呼吸支持时间、肺表面活性物质（PS）的使用情况、治疗失败率、支气管肺发育不良（BPD）和早产儿视网膜病变（ROP）的发生率，以及血气pH值、氧分压和二氧化碳分压的变化。评估两组的安全性。
结果
BNCPAP组和nCPAP组在性别分布、胎龄、出生体重、出生后1分钟和5分钟的Apgar评分、分娩方式及NRDS严重程度方面差异均无统计学意义（P>0.05）。BNCPAP组无婴儿死亡，nCPAP组有1例婴儿死亡；两组死亡率差异无统计学意义（P>0.05）。两组在无创通气时间、治疗失败率、BPD和ROP发生率以及需要使用或再次使用PS的婴儿比例方面差异均无统计学意义（P>0.05）。通气8 - 12小时后，两组血气pH值和氧合指数变化差异无统计学意义（P>0.05），而BNCPAP组二氧化碳分压下降幅度明显大于nCPAP组（P<0.05）。两组气胸、鼻中隔损伤和鼻黏膜损伤发生率差异无统计学意义（P>0.05）。
结论
BNCPAP和nCPAP对NRDS早产儿进行呼吸支持的临床效果和安全性相似。
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