Clinical Stady Of Nasal Duo Positive Airway Pressure Ventilation In The Treatment Of Preterm Infants With Respiratory Distress Syndrome

Objective:To investigate the effect of nasal duo positive airway pressure?DuoPAP?in the treatment of preterm infants with respiratory distress syndrome?RDS?.Methods:This paper selected 79 preterm infants hospitalized in Tai'an City Maternal and child health care hospital in 2015 from January to December as the research object,who have been born within 6 hours and were diagnosed of neonatal respiratory distress syndrome?RDS?and need no invasive respiratory support.According to the gestational age,birth weight,age and so on these children were randomly divided into two groups,39 cases as the Group DuoPAP,and the other 40 cases as the NCPAP group.Patients in observation group were treated with duo positive pressure ventilation?DuoPAP?after the application of InSurE strategy,while the control group was treated with NCPAP after InSurE.The clinical symptoms,signs,blood gas changes and oxygenation index?OI?were recorded after 2 hours,12 hours,24 hours,48 hours and 72hours after the treatment.The rate of mechanical ventilation,noninvasive respiratory support time,hospital stay and hospitalization cost were recorded in 72 hours.The incidences of complications such as apnea,retinopathy of prematurity,pneumothorax,bronchopulmonary dysplasia,intracranial hemorrhage and necrotizing enterocolitis were recorded.Results:The arterial oxygen partial pressure in 2h,12h?p<0.05?in the DuoPAP group was higher than that in the NCPAP group,and the difference was statistically significant.There was no significant difference in 24h,48h,72h?p>0.05?.The oxygenation index?OI?of the DuoPAP group improved faster within 12 hours?p<0.05?,and the difference was statistically significant.After 24 hours?p>0.05?,there was no significant difference between the two groups.The pH continued to rise after the application of PS,and the acidosis could be corrected.In the first 12 hours?p<0.05?,the pH in the DuoPAP group increased significantly?P<0.05?.After 24 hours of treatment,the difference was no longer statistically significant?P>0.05?.After 2 hours of treatment?p=0.003?,PaCO₂ was significantly decreased in the DuoPAP group compared with the NCPAP group?P<0.01?.This significant difference sustained 24 hours?p<0.05?.After 48 hours,the decreasing had no longer statistical difference?P>0.05?.The total noninvasive respiratory support time?p=0.045?of the DuoPAP group was lower than in the NCPAP group.The intubation and respiratory support?p=0.027?as well as the repetition rate of using PS?p=0.027?in 72h of the DuoPAP group was lower than that of the group NCPAP?p=0.03?,and the hospitalization time shortened and the cost of hospitalization?p=0.013?decreased.There was no significant difference between the DuoPAP group and the NCPAP group in the complications such as pneumothorax,bronchopulmonary dysplasia,intracranial hemorrhage,retinopathy,etc as well as the mortality?p>0.05?.There was no difference between the two groups in the time of recovery of birth weight?p=0.296?,total enteral feeding time?p=0.411?and the weight gaining rate?p=0.459?.Conclusions:1.The DuoPAP combined with InSurE technique in the treatment of preterm infants with RDS can improve gas exchange better,avoid invasive ventilation to the greatest extent,reduce hospitalization time and time on ventilator,shorten the hospital stay,and reduce the medical treatment.2.The combination of DuoPAP and InSurE technology can play a greater role in PS,and reduce the demand for additional PS of the children.