【摘要】 目的:分析联用NIPPV及PS治疗对NRDS患儿临床疗效以及预后结局的影响。方法:从本院2017年4月～2020年4月期间入院的NRDS患儿中选取80例作为研究目标,依据随机数字表法进行分组,分为观察组（NIPPV+PS）、对照组（CPAP+PS）,每组均为40例。对比观察各组患儿的临床疗效、预后、治疗结局与并发症情况,多因素回归分析NIPPV+PS联合治疗对NRDS患儿并发症的影响。结果:两组患儿治疗后呼吸频率、心率相比于治疗前均明显降低,观察组患儿治疗后的呼吸频率、心率明显低于对照组;两组患儿治疗后PaCO₂相比于治疗前均明显降低,pH、PaO₂、PaO₂/FiO₂均明显上升,观察组患儿治疗后的PaCO₂明显低于对照组,pH、PaO₂、PaO₂/FiO₂明显高于对照组,组间及组内数据差异均具有统计学意义;观察组患儿的支气管肺发育不良并发症发生率与对照组无明显差异,差异无统计学意义;观察组患儿的撤机治愈比例明显高于对照组,病情加重应用气管插管或有创呼吸机辅助通气比例明显低于对照组,组间数据差异具有统计学意义;多因素Logistic回归分析结果显示,NRDS患儿应用NIPPV+PS联合治疗对其继发支气管肺发育不良并发症的风险无明显影响。结论:PS+CPAP是NRDS患儿临床治疗的良好方案,NIPPV+PS联合治疗在改善NRDS患儿的临床症状、提升治疗效果方面具备更高的应用价值,并且不会增加并发症的发生风险,安全性较高,有利于改善患儿的临床预后结局,具备推广应用的价值。更多还原

【Abstract】 Objective To analyze the effect of combined NIPPV and PS treatment on the clinical efficacy and prognosis of children with NRDS.Methods From April 2017 to April 2020 in our hospital,80 children with NRDS were selected as the research target,grouped according to the random number table method,and divided into observation group（NIPPV+PS） and control group（CPAP+PS）,each group is 40 example.The clinical efficacy,prognosis,treatment outcome and complications of children in each group were compared and observed.Multivariate regression analysis was used to analyze the influence of NIPPV+PS combined treatment on the complications of children with NRDS.Results The respiratory frequency and heart rate of the two groups of children after treatment were significantly lower than those before the treatment.The respiratory frequency and heart rate of the observation group were significantly lower than those of the control group;the PaCO₂ of the two groups of children after treatment was significantly lower than that before treatment Decrease,pH,PaO₂,PaO₂/FiO₂ all increased significantly.PaCO₂ of the observation group after treatment was significantly lower than that of the control group,pH,PaO₂,PaO₂/FiO₂ were significantly higher than that of the control group,data between and within groups The differences were statistically significant;the incidence of bronchopulmonary dysplasia in the observation group was not significantly different from that of the control group,and the difference was not statistically significant;the rate of weaning cure in the observation group was significantly higher than that of the control group In the control group,the proportion of patients with aggravated illness who used tracheal intubation or invasive ventilator assisted ventilation was significantly lower than that of the control group,and the data difference between the groups was statistically significant;the results of multivariate logistic regression analysis showed that children with NRDS used NIPPV +PS combination therapy has no significant effect on the risk of secondary bronchopulmonary dysplasia complications.Conclusion PS is a good plan for the clinical treatment of children with NRDS.The combined treatment of NIPPV+PS has higher application value than the single application in improving the clinical symptoms of children with NRDS and enhancing the treatment effect,and does not increase complications.Occurrence risk,high safety,is conducive to improving the clinical prognosis of children,and has the value of promotion and application.更多还原