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目的:比较鼻塞持续气道正压通气(NCPAP)与气管插管接呼吸机通气治疗早产极低出生体重儿呼吸窘迫综合征(NRDS)的临床效果。方法:117例存在NRDS的早产极低出生体重儿随机分为观察组78例,给予NCPAP治疗;对照组39例,给予气管插管后常频机械通气(CMV)治疗,观察两组临床疗效、血气分析指标变化及并发症。结果:与对照组比较,观察组呼吸支持治疗时间、住院天数、治疗成功率及预后良好率均无统计学差异(P<0.05)。血气分析指标比较,观察组6 h后PaO2明显低于对照组(P<0.05),而治疗前及治疗后12 h、24 h各项指标均无统计学差异(P>0.05);与治疗前比较,两组治疗后6 h、12 h及24 h PaO2均显著升高(P<0.05),PaCO2显著降低(P<0.05)。观察组并发症发生率显著低于对照组(21.8%vs.28.2%,P<0.05)。结论:NCPAP与气管插管接呼吸机通气均能显著改善NRDS的早产极低出生体重儿症状,二者疗效相近,而NCPAP并发症发生率更低。
Objective: To compare the clinical efficacy of nasal continuous positive airway pressure (NCPAP) and endotracheal intubation with ventilator for treatment of respiratory distress syndrome (NRDS) in preterm very low birth weight infants. Methods: A total of 117 preterm and very low birth weight infants with NRDS were randomly divided into observation group (n = 78) and NCPAP treatment group (n = 39). The control group received routine mechanical ventilation (CMV) after tracheal intubation. The clinical efficacy, Blood gas analysis changes and complications. Results: Compared with the control group, there was no significant difference (P <0.05) in respiratory support treatment time, hospitalization days, treatment success rate and good prognosis in observation group. Compared with the blood gas analysis index, the PaO2 in the observation group was significantly lower than that in the control group (P <0.05) after 6 h, while there was no significant difference between before treatment and 12 h and 24 h after treatment (P> 0.05) PaO2 was significantly lower (P <0.05) at 6 h, 12 h and 24 h after treatment in both groups. The incidence of complications in observation group was significantly lower than that in control group (21.8% vs.28.2%, P <0.05). CONCLUSION: Both NCPAP and ventilator intubation with ventilator can significantly improve the symptoms of preterm and very low birth weight infants in NRDS. The efficacy of NCPAP is similar to that of NCPAP, but the incidence of NCPAP complications is lower.