关键词: 经鼻间歇正压通气, 双水平正压通气, 经鼻持续气道正压通气, 呼吸窘迫综合症, 早产儿, 撤机

Abstract:

Objective To investigate the clinical efficacy of nasal intermittent positive pressure ventilation（NIPPV），bilevel positive airway pressure（BiPAP）and nasal continuous positive airway pressure（NCPAP）inpremature infants with respiratory distress syndrome（RDS）after extubation. Methods According to the respiratorysupport methods after extubation，70 premature infants with RDS were divided into NIPPV group（n = 20），BiPAPgroup（n = 24），and NCPAP（n = 26）. The indexes of blood gas analysis，success rate of extubation within one weekand complications before and after noninvasive ventilation were analyzed. Results There was no significant differ⁃ence in PaO2 and PaCO2 among the three groups before extubation（P > 0.05）. There was no statistically significantdifference between NIPPV group and BiPAP group in terms of 6 h PaO2 and 12 h PaO2 after non⁃invasive ventila⁃tion（P > 0.05），which were higher than those in NCPAP group（P < 0.05），indicating statistical significance. 6 hPaCO2 was the lowest in the NIPPV group，and the highest in the NCPAP group and pairwise comparison amongthe three groups was statistically significant（P < 0.05）. There was no significant difference in 12 h PaCO2 betweenthe NIPPV group and the BiPAP group（P > 0.05），which was lower than that in the NCPAP group（P < 0.05）. Theincidence of abdominal distension in the NIPPV group during noninvasive ventilation was significantly lower thanthat in the BiPAP group and the NCPAP group（P < 0.05）. The incidences of internal extubation failure within 7 days，pneumothorax，intracerebral hemorrhage，or bronchopulmonary dysplasia were not statistically significant in thethree groups（P > 0.05）. The incidence of abdominal distension in the NIPPV group was lower than that in theBiPAP group or the NCPAP group，and the difference was statistically significant（P < 0.05）. Conclusion As atransitional mode after the extubation in premature infants with RDS，both NIPPV and BiPAP can improve thepulmonary ventilation function. Attention should be paid to avoid low PaCO2 in the use of NIPPV.The use of BiPAPor NCPAP requires attention to the occurrence of abdominal distension.

Key words: nasal intermittent positive pressure ventilation, bilevel positive airway pressure, nasal continuous positive airway pressure, respiratory distress syndrome, premature infant, extubation