Clinical Efficacy Of CPAP In The Treatment Of Neonates With Transient Tachypnea Of The Newborn

Objective:To investigate the clinical efficacy of nasal continuous positive airway pressure（CPAP）in the treatment of middle and late preterm infants with Transient tachypnea of the newborn（TTN）and to retrospectively analyze the diagnosis and treatment of TTN in the past five years,and to compare the past with the current.Methods:From March 2018 to February 2019 in The First Affiliated Hospital of Hainan Medical College,41 preterm infants who’s gestational age were between32weeks and 36weeks with TTN,were examined by emergency pulmonary ultrasound and chest X-ray after admission,and the results were recorded.They were divided into observation group and control group randomly.There were 20 cases in the observation group and 21 cases in the control group.Both of them were treated with conventional therapy.Moreover,the observation group was treated with nasal CPAP（FiO₂=21%）,the control group was treated with breathing air in the normal atmospheric pressure.The TTN clinical score,respiratory rate and percutaneous blood oxygen saturation were recorded at admission and after treatment in 30 minutes.At the same time,it was recorded that the hospitalization time,whether to start the emergency plan and complication of the two group.In addition,It was collected that clinical data of 42 infants who were full-term in the majority with TTN in the neonatal department of our hospital from January 2013 to January 2018,including gestational age,birth weight,maternal pregnancy,treatment,hospitalization time and complications.Results:According to the data collected,there were statistically significant differences between the observation group and the control group in the total effective rate of treatment,TTN clinical score after 30 minutes of treatment and the probability of starting emergency plan（P<0.05）.The respiratory frequency,TTN clinical score and percutaneous oxygen saturation in two groups were compared at admission and30 minutes after treatment,the differences were statistical significance（P<0.05）.There was no statistically significant difference in respiratory rate and percutaneous oxygen saturation between the two groups after 30 minutes of treatment（P>0.05）.At the same time,there was no statistically significant difference in the incidence of complications and hospitalization time between the two groups（P>0.05）.The accuracy of ultrasonic diagnosis of TTN was 97.56%.In the past five years,among the 42 TTN infants in our hospital,the hospitalization time of full-term infants（25cases）was shorter than that of preterm infants（17 cases）（t=-2.947,P<0.05）,and there was no significant difference in the probability of using respiratory support between full-term infants and preterm infants（c²=2.224,P>0.05）.Conclusion:Early application of CPAP（FiO₂=21%）can significantly improve the symptoms of dyspnea in TTN premature infant and reduce the probability of oxygen use.The accuracy of ultrasonic diagnosis of TTN is high.Ultrasonic testing is safe,radiation-free and easy to operate,which is worthy of promotion and application in NICU.Among the neonates diagnosed with TTN in the past five years,the term infants were more than preterm infants,and the condition was relatively mild.Most of them could be cured by conventional treatment,and the length of hospitalization was relatively short.Some of them needed mechanical ventilation to assist breathing.In the past five years,the clinicians in our hospital believed that the majority of premature infants with dyspnea were neonatal respiratory distress syndrome other than infection and asphyxia,lacking the awareness to diagnose TTN of premature infants,so the number of TTN cases was relatively small,and most of them were full-term infants.