The Efficacy And The Effect On Prognosis Of Different Modes Of Respiratory Support In Treatment For Neonatal Respiratory Distress Syndrome

Objective:To compare the efficacy and the incidence rate of invasive ventilation and multicomplications between early duo positive airway pressure and nasal continuous positive airway pressure in treatment for neonatal respiratory distress syndrome in order to explore the efficacy and the effect on all kinds of related complications of two different modes of respiratory support and guide the treatment for neonatal respiratory distress syndrome. Methods:80 newborns who were diagnosed neonatal respiratory distress syndrome in newborn intensive care of our hospital from January,2012 to November,2013 were looked on as observed group.All of them were met the diagnosis criteria of neonatal respiratory distress syndrome according to the Practice of neonatology Fourth Edition.Newborns who were diagnosed neonatal respiratory distress syndrome were divided into Duo PAP group(38 cases) and NCPAP group(42 cases) randomly. All of them were given replacement therapy with pulmonary surfactant and routine suitable-symptom nutritional supporting treatment(keep normal blood pressure, blood oxygen, acid-base balance, nutritional support and so on). The clinical information, total time in hospital and hospitalization expenses were analyzed. The success rate, the death rate, the time of ventilation assisted respiration and the incidence rate of complications(air leak, ventilator-associated pneumonia, gastrointestinal complications, intracranial hemorrhage, bronchopulmonary dysplasia, injury of nasal mucosa and so on) were recorded and analyzed by statistic so as to research the effect of different modes of respiratory support on above actors by multilevel. The therapeutic regimens of both groups were passed by Medical Ethical Committee of the Second People’s Hospital Of Liao cheng and were agreed by the family members.The data were analyzed with SPSS 13.0 software. The count data were analyzed by normal testing and T Test. Normal distribution data were represented by compared by ±s and count data were represented by percent. The comparison of means of both groups were by t test and the comparison of rate of both groups were by X2 test or Fisher exact probability test. Distribution data were represented by M(IQR).The comparison of both groups were by rank-sum test. P <0.05 had no statistical significance. Results:1.The comparison of general situations: There were no obviously statistical significance in hospital admission time, birth weight, gestational age, time of given PS, sex-ratio, delivery mode and the severity degree of RDS.2.The comparison of the time of ventilation respiratory support and treatment by oxygen: The time of ventilation respiratory support and treatment by oxygen in Duo PAP group were shorter than that in NCPAP group. There were obviously statistical significance(P<0.05).The total time in hospital and the expenses were reduced by shortening the time of ventilation respiratory support and treatment by oxygen. The difference had statistical significant( P<0.05).3. The comparison of success rate: The success rate in Duo PAP group was higher than that in NCPAP group. The difference had statistical significant( P<0.05).The rate of trachea incubation after invasive ventilation in Duo PAP group was less than that in NCPAP group. The difference had statistical significant( P<0.05).4. The comparison of complications: It showed that there were no obviously statistical significance in the incidence rate of ventilator-associated pneumonia, gastrointestinal complications, intracranial hemorrhage and bronchopulmonary dysplasia between two groups by X2 test or Fisher exact probability test(P>0.05).The incidence rate of air leak and injury of nasal mucosa were lower in NCPAP group than that in Duo PAP group. The difference had statistical significant( P<0.05). Conclusions:Duo PAP was superior to the NCPAP in treatment for RDS. Newborns with neonatal respiratory distress syndrome treated by Duo PAP can shorten the time of ventilati-on respiratory support and treatment by oxygen and can reduce the total time in ho-spital and hospitalization expenses. There was no obviously statistical significance i-n the improvement of oxygen saturation between two groups. But the improvement of CO2 retention in Duo PAP group was superior to that in NCPAP group. The c-hange of Pa CO2 in Duo PAP group was higher than that in NCPAP group after six hours treatment. There were no obviously statistical significance in the incidence r-ate of ventilator-associated pneumonia, gastrointestinal complications, intracranial he-morrhage,bronchopulmonary dysplasia and death between two groups. The rate of trachea incubation after invasive ventilation in NCPAP group was higher than that in Duo PAP group. Different to most research, the incidence rate of air leak and injury of nasal mucosa were lower in NCPAP group than that in Duo PAP group which duo to the higher airway pressure of Duo PAP. At the same time, the time that we used the Duo PAP is shorter and the nursing experience is deficient.