鼻塞式同步间歇指令通气在早产儿原发性呼吸暂停中的应用

Application of nasal synchronized intermittent mandatory ventilation in the primary apnea of prematurity

关键词:  早产儿原发性呼吸暂停  鼻塞式同步间歇指令通气  鼻塞式持续气道正压通气

Key words:  [Key words]　primary apnea of premature  nasal synchronized intermittent mandatory ventilation  nasal continuous positive airway pressure ventilation

摘要:

[摘要]　目的　分析鼻塞式同步间歇指令通气（nSIMV）在早产儿原发性呼吸暂停（AOP）中的临床应用效果。　方法　应用nSIMV模式治疗AOP早产儿共22例，与既往应用鼻塞式持续气道正压通气（nCPAP）模式治疗的AOP早产儿共22例进行分析，比较两组患儿治疗前后临床症状、血气指标、治疗效果及预后的变化。　结果　经nSIMV模式治疗的婴儿每小时呼吸暂停发生频率以及心率下降频率比经nCPAP模式治疗的早产儿明显降低，差异有显著性意义（P<0.05)，nSIMV组需气管插管行呼吸机通气的比率(9.1%)、CO2潴留比率(4.5%)和胃肠道并发症比率(4.5%)明显低于nCPAP组(27.3%、18.2%和13.6%)，差异有显著性意义（P<0.05)。　结论　nSIMV能更有效地对AOP早产儿进行呼吸支持治疗。

Abstract:

[Abstract] Objective　To evaluate the efficacy of nasal synchronized intermittent mandatory ventilation (nSIMV) in preterm infants with primary apnea of premature (AOP).　Methods　We collected 22 cases of preterm infants with AOP who were treated with nSIMV，and compared with 22 cases who were previously treaded with nasal continuous positive airway pressure (nCPAP). Clinical symptoms，signs and blood gas results following nSIMV or nCPAP in the two groups were compared.　Results　The infants receiving nSIMV had a greater reduction of apneic spells and a greater decrease in bradycardia than those receiving nCPAP. Compared to the nCPAP group，the nSIMV group had a lower incidence of respiratory failure (9.1% vs. 27.3%; P<0.05)，a lower incidence of hypercarbonia (4.5% vs. 18.2%; P<0.05) and a lower incidence of gastrointestinal complications (4.5% vs. 13.6%; P<0.05).　Conclusion　nSIMV is more effective in respiratory support in preterm infants with AOP.