经鼻持续气道正压通气治疗新生儿肺炎临床疗效评定

The Effect of Nosal Continuous Positive Airway Pressure in Premative Infants with Pneumonia

目的评价经鼻持续气道正压通气(NCPAP)与常规头罩或鼻导管吸氧对新生儿肺炎的治疗效果以及NCPAP在缩短病程,降低机械通气需求等方面的优越性。方法对75例在我院新生儿科住院治疗的新生儿肺炎进行临床疗效观察,随机分为两组,NCPAP治疗组42例和普通通气对照组33例,动态监测两组患儿治疗前、治疗1h、8h、12h的动脉血气并进行比较。NCPAP治疗组应用德国STEPHAN CPAP-A呼吸机通气,普通通气组采用鼻导管或头罩吸氧。结果两组患儿治疗12h时氧分压及二氧化碳分压均值间差别均有显著性意义(P<0·01);两组患儿的病程及机械通气率间差别均有显著性意义(P<0·01)。结论NCPAP治疗新生儿肺炎的疗效明显优越于普通通气,能有效改善患儿肺氧合,缩短病程,降低机械通气率,是治疗新生儿肺炎非常有效的通气方式。

Objective To determine the effect of nosal continuous positive airway pressure （NCPAP） compared to conventional inhale oxygen. Methods 75 infants with pneumonia in our hospital were divided into two groups randomly. 42 newborns with pneumonia in experimental group were treated with NCPAP. 33 newborns in control group were treated with conventional inhale oxygen. Blood samples have been taken in four times （before treatment and 1 h, 8 h, 12 h after treatment）. Results At the 12 h in experimental group after treatment, the arterial oxygen tension （ PaO2 ） increased from （ 53.4 ± 3.6 ） mm Hg to （ 95.0 ± 9.3 ） mm Hg, arterial carbor dioxide tension （ PaCO2 ） decreased from （ 46. 1 ± 4. 1 ） mm Hg to （ 36. 5 ± 4. 5） mm Hg. There were significant differences among them （ P 〈 0. 01 ） . In control group, the PaO2 increased from （ 54. 9 ±4. 1） mm Hg to （66. 9 ±7.0） mm Hg, but there were no significant differences among them （ P 〉0. 05）. Conclusion NCPAP can improve the oxygenation of infants with pneumonia and decrease the invasive durations of ventitalory support, the rate of the endotracheal intubation and the durations of ICU stay.