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目的探讨经鼻双水平正压通气联合咖啡因治疗早产新生儿呼吸窘迫综合征的临床效果。方法回顾性分析崇左市人民医院2016年2月—2017年2月收治的早产新生儿呼吸窘迫综合征患儿72例,按照随机数字表法将所有患儿分为对照组与观察组,各36例。对照组患儿予以经鼻持续气道正压通气+氨茶碱治疗,观察组患儿予以经鼻双水平正压通气+咖啡因治疗,持续监测7 d,若患儿症状未加重,则立即停止药物治疗。比较两组患儿拔管后1 h、12 h时pH值、动脉血二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)水平,观察两组患儿并发症及拔管失败发生情况。结果拔管后1 h、12 h,观察组患儿PaCO_2低于对照组,PaO_2高于对照组(P<0.05);拔管后1 h、12 h,两组患儿pH值比较,差异无统计学意义(P>0.05)。观察组患儿并发症发生率、拔管失败率低于对照组(P<0.05)。结论经鼻双水平正压通气联合咖啡因治疗早产新生儿呼吸窘迫综合征的临床效果确切,可有效提升患儿的呼吸功能,降低拔管失败率,且安全性高。
Objective To investigate the clinical effect of nasal biphasic positive pressure ventilation combined with caffeine in the treatment of respiratory distress syndrome in premature neonates. Methods Retrospective analysis of 72 cases of neonatal respiratory distress syndrome of premature neonates admitted to Chongzuo People’s Hospital from February 2016 to February 2017. All children were divided into control group and observation group according to random number table 36 cases. Children in the control group were treated with nasal continuous positive airway pressure plus aminophylline. Patients in the observation group were treated with positive nasal biphasic positive pressure ventilation and caffeine for 7 days. If the symptoms were not aggravated immediately Stop medication. The pH value, PaCO_2 and PaO_2 levels were compared between the two groups at 1 h and 12 h after extubation. The complication and extubation failure were observed in both groups. Results After 1 and 12 h of extubation, PaCO 2 in the observation group was lower than that in the control group and PaO 2 was higher than that in the control group (P <0.05). At 1 h and 12 h after extubation, there was no significant difference in pH value between the two groups Statistical significance (P> 0.05). The incidence of complication in the observation group was lower than that in the control group (P <0.05). Conclusion Nasal bilevel positive pressure ventilation combined with caffeine in the treatment of premature neonatal respiratory distress syndrome has the exact clinical effect, which can effectively improve children’s respiratory function, reduce the failure rate of extubation, and is safe.