经鼻同步间歇正压通气与头罩吸氧对早产儿机械通气后过渡性撤机的影响

陈爱斌; 李志鸿; 沈伊娜

doi:10.13898/j.cnki.issn.1000-2200.2019.02.025

经鼻同步间歇正压通气与头罩吸氧对早产儿机械通气后过渡性撤机的影响

Comparative study of the effect of NIPPV and oxygen hood on the transition tripper in preterm infants after mechanical ventilation

摘要

摘要:
目的研究经鼻同步间歇正压通气（SNIPPV）与头罩吸氧对早产儿机械通气后过渡性撤机的影响。
方法将呼吸窘迫综合征早产儿40例作为研究对象，随机分为观察组和对照组，各20例。观察组给予SNIPPV，对照组给予头罩吸氧，比较2组撤机后不同时间动脉二氧化碳分压（PaCO₂）和氧分压（PaO₂）水平，并比较2组氧疗时长、住院时间、呼吸暂停发生率、撤机成功率和并发症情况。
结果撤机后12、24 h，观察组早产儿PaO₂水平均高于对照组（P < 0.05和P < 0.01），PaCO₂水平均低于对照组（P < 0.05）；撤机后48 h，2组PaO₂和PaCO₂水平差异均无统计学意义（P > 0.05）。观察组氧疗时长与住院时间均明显短于对照组（P < 0.01）。观察组撤机成功率为85.0%，高于对照组的55.0%（P < 0.05）；呼吸暂停发生率为20.0%，低于对照组的50.0%（P < 0.05）。2组并发症发生率差异无统计学意义（P > 0.05）。
结论早产儿机械通气后过渡性撤机中应用SNIPPV可降低呼吸暂停发生率，有效缩短住院与氧疗时间，改善氧合状态，提高撤机成功率。

Abstract:
ObjectiveTo compare the effects between nasal synchronized intermittent positive pressure ventilation(SNIPPV) and oxygen hood on the transition tripper in preterm infants after mechanical ventilation.
MethodsForty preterm infants with pediatric respiratory distress syndrome were randomly divided into the observation group and control group(20 cases each group).The observation group and control group were treated with SNIPPV and oxygen hood, respectively.The levels of PaCO₂ and PaO₂ between two groups at different time-points after weaning were compared.The oxygen therapy time, hospitalization time, incidence of apnea, success rate of weaning, and incidence rate of complications between two groups were compared.
ResultsThe levels of PaO₂ in observation group after 12 and 24 h after weaning were higher than that in control group(P < 0.05 and P < 0.01), and the levels of PaCO₂ in observation group were lower than that in control group(P < 0.05).The differences of the levels of PaO₂ and PaCO₂ between two groups after 48 h of weaning were not statistically significant(P > 0.05).The oxygen therapy time and hospitalization time in observation group were significantly shorter than those in control group(P < 0.01).The success rate of weaning in observation group(85.0%) was higher than that in control group(P < 0.05).The incidence rate of apnea in observation group(20.0%) was lower than that in control group(50.0%)(P < 0.05).The differences of the incidence rate of complications between two groups was not statistically significant(P > 0.05).
ConclusionsThe application of SNIPPV in transition tripper in preterm infants after mechanical ventilation can decrease the incidence rate of apnea, effectively shorten the oxygen therapy time and hospitalization time, and improve the oxygenation and success rate of weaning.

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