目的:对比观察双水平正压通气(DuoPAP)及鼻塞持续正压通气(NCPAP)在早产儿肺透明膜病(HMD)治疗中的临床疗效与安全性,以期为HMD的临床治疗提供指导.方法:选取2014年1月~2016年6月间我院收治的HMD患儿68例,随机分成对照组(n=34)与观察组(n=34).两组均给予固尔苏治疗,对照组在此基础上给予NCPAP治疗,而观察组给予DouPAP治疗.观察并记录两组患者治疗前及治疗1、12、24h后的动脉血气指标、氧合指数(OI),同时比较其临床疗效、治疗期间的通气、氧疗及住院时间,以及并发症发生情况.结果:对照组治疗12、24h后的pH、氧分压(PaO2)、二氧化碳分压(PaCO2)及OI较治疗前均显著改善,而观察组治疗1、12、24h后的上述各指标较治疗前也显著改善,差异均有统计学意义;且观察组治疗24h后的pH,治疗12、24h后的PaO2、PaCO2及OI改善程度均优于对照组,差异有统计学意义;同时观察组治疗有效率(91.18%)略高于对照组(85.29%),但差异无统计学意义,且其通气、氧疗及住院时间也均短于对照组,差异有统计学意义;观察组的并发症发生率(14.71%)显著低于对照组(26.47%),差异有统计学意义.结论:相比于鼻塞持续正压通气,双水平正压通气在改善患儿动脉血气指标、临床症状方面的效果更为显著,且治疗效率及安全性更高,在HMD的临床治疗上存在重要价值.%Objective To observe the bi level positive airway pressure(DuoPAP)and nasal continuous positive airway pres-sure (NCPAP) in premature infants with hyaline membrane disease (HMD) clinical efficacy and safety of treatment, in order to provide guidance for the clinical treatment of HMD. Methods 68 children with HMD in our hospital from January 2014 to June 2016 were randomly divided into control group (n=34) and observation group (n=34). The two groups were given Curo-surf treatment, the control group was given NCPAP treatment, while the observation group was treated with DouPAP. The two groups were observed and recorded before treatment and 1, 12, 24h after the arterial blood gas index, oxygenation index (OI), and to compare the clinical efficacy and treatment during ventilation, oxygen therapy and hospitalization time and the incidence of complications. Results The treatment of control group, 1224h after pH, the oxygen partial pressure (PaO2), partial pressure of carbon dioxide (PaCO2) and OI were significantly improved, and the observation group for 1, 12, 24h after the index before treatment was significantly improved, the differences were statistically significant;in the observation group after the treatment of 24h pH, 12, 24h after the treatment of PaO2, PaCO2 and OI were more improved than the control group, the difference was sta-tistically significant;at the same time, the treatment efficiency of observation group (91.18%) was slightly higher than that of the control group (85.29%), but the difference was not statistically significant and, the ventilation, oxygen therapy and hospitaliza-tion time were shorter than the control group, the difference was statistically significant;the incidence of the complications in the observation group (14.71%) was significantly lower than the control group (26.47%), the difference was statistically significant. Conclusion Compared with nasal continuous positive airway pressure, bi level positive pressure ventilation in children improve arterial blood gas indexes and clinical symptoms of the effect is more significant, and the treatment efficiency and higher safety,has important value in the clinical treatment of HMD.
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