摘要 目的：比较经鼻同步间歇正压通气（NSIPPV）与经鼻持续气道正压通气（NCPAP）治疗早产儿呼吸暂停的疗效。方法：将2010年8月至2011年1月住院的80例呼吸暂停早产儿随机分为NSIPPV组与NCPAP组，每组40例，比较治疗前、治疗后2 h血气分析结果、上机时间、疗效和并发症。结果：治疗前两组血气分析结果的差异无统计学意义（P＞0.05），治疗后2 h NSIPPV组的pH值、PaO2、PaCO2均明显优于NCPAP组（P＜0.05）；NSIPPV组上机时间（50±9 h）明显短于NCPAP组（91±11 h），差异有统计学意义（P＜0.01）；两组治疗的总有效率（95% vs 85%）差异无统计学意义（P＞0.05），但NSIPPV组3 d 内撤机的比例（23/40）明显高于NCPAP组（14/40）（P＜0.05）；两组并发症发生比率（22% vs 25%）差异无统计学意义（P＞0.05）。结论：NSIPPV治疗早产儿呼吸暂停比NCPAP更有优势。
Abstract：OBJECTIVE: To compare the efficacy of nasal synchronized intermittent positive pressure ventilation (NSIPPV) and nasal continuous positive airway pressure ventilation (NCPAP) for the treatment of apnea in preterm infants. METHODS: Eighty preterm infants with apnea from August 2010 to January 2011 were randomly administered with NSIPPV and NCPAP (n=40 each).The blood gas results before and 2 hrs after ventilation, time of using ventilator, therapeutic efficacy and complications were compared between the two groups. RESULTS: There were no significant differences in the blood gas results between the two groups before ventilation. The blood gas results (pH, PO2, PCO2) in the NSIPPV group were better than those in the NCPAP group 2 hrs after ventilation. The time of using ventilator in the NSIPPV group was shorter than that in the NCPAP group (50±9 h vs 91±11 h; P0.05). The proportion of ventilator weaning within 3 days in the NSIPPV group (23/40) was higher than that in the NCPAP group (14/40) (P<0.05). The incidence of complications in the NSIPPV group was not different from that in the NCPAP group (22% vs 25%). CONCLUSIONS: NSIPPV appears to be superior to NCPAP for the treatment of apnea in preterm infants.
LIN Xin-Zhu,ZHENG Zhi,LIN Ya-Yin et al. Nasal synchronized intermittent positive pressure ventilation for the treatment of apnea in preterm infants[J]. CJCP, 2011, 13(10): 783-786.
［7］Santin R, Brodsky N, Bhandari V. A prospective observational pilot study of synchronized nasal intermittent positive pressure ventilation(SNIPPV) as primary mode of ventilation in infants >or=28 weeks with respiratory distress syndrome (ROS)［J］. J Perinatol, 2004, 24(8): 487-493.
［8］Davis PG, Morley CJ, Owen LS. Non-invasive respiratory support of preterm neonates with respiratory distress: continuous positive airway pressure and nasal intermittent positive pressure ventilation［J］.Semin Fetal Neonata Med, 2009, 14(1): 14-20.
［9］Lampland AL, Meyers PA, Worwa CT, Swanson EC, Mammel MC. Gas exchange and lung inflammation using nasal intermittent positive-pressure ventilation versus synchronized intermittent mandatory ventilation in piglets with saline-lavage-induced lung injury: an observational study［J］.Crit Care Med, 2008, 36(1): 183-187.
［10］Lin CH, Wang ST, Lin YJ, Yeh TF. Efficacy of nasal intermittent positive pressure ventilation in treating apnea of prematurity［J］.Pediatr Pulmonol, 1998, 26(5): 349-353.
［11］Kiciman NM, Andréasson B, Bernstein G, Mannino FL, Rich W, Henderson C, et al. Thoracoabdominal motion in newborns during vetilation delivered by endotracheal tube or nasal prongs［J］. Pediatr Pulmonol, 1998, 25(3): 175-181.
［12］Moretti C, Gizzi C, Papoff P, Lampariello S, Capoferri M, Calcagnini G, et al. Comparing the effects of nasal synchronized intermittent positive pressure ventilation（nSIPPV）and nasal continuous positive airway pressure（nCPAP）after extubation in very low birth weight infants［J］.Early Hum Dev, 1999, 56(2-3): 167-177.
［13］Migliori C, Motta M, Angeli A, Chirico G. Nasal bilevel vs. continuous positive airway pressure in preterm infants［J］. Pediatr Pulmonol, 2005, 40(5): 426-430.
