鼻塞持续气道正压通气治疗新生儿呼吸衰竭

Nasal continuous positive airway pressure ventilation in the treatment of neonatal respiratory failure in clinical observation

目的探讨经鼻塞呼吸道正压给氧疗法(nCPAP)为主的综合治疗对新生儿呼吸衰竭的临床疗效。方法将110例呼吸衰竭新生儿随机分为治疗组和对照组,治疗组56例普通给氧无效换用nCPAP,无效者应用呼吸机,尽早撤机后再行nCPAP治疗;对照组54例,鼻导管与头罩吸氧无效者直接用呼吸机。检测治疗组用鼻导管吸氧与nCPAP两种治疗方法后其血气指标变化情况。结果治疗组经nCPAP治疗后,动脉氧分压(PaO2)显著升高(P<0.01),动脉二氧化碳分压(PaCO2)显著降低。观察组插管几率、呼吸道损伤率、再插管率、呼吸机相关性肺炎发生率均显著低于对照组(P<0.05);总治愈率与对照组比较差异无统计学意义(P>0.05)。结论在综合治疗的基础上,nCPAP疗法对新生儿呼吸衰竭的治疗安全有效,简便易行,可有效降低呼吸机应用的相关风险。

Objective To evaluate the clinical curative effect about the oxygen therapy nasal positive airway pressure（nCPAP）-based,integrated treatment of neonatal respiratory failure.MethodsOne hundred and ten newborns with respiratory failure were randomly divided into treatment group and control group,The treatment group,56 cases,when normal oxygen treatment was invalid,replace nCPAP treatment,if it was also invalid,replace breathing machines again.When the treatment of breathing machine treatment was over,the nCPAP therapy immediately begin.The control group,54 cases,when the treatment of nasal catheter and hood was invalid,the oxygen breathing machine was used directly.Contrast the changes of their arterial blood gas between the two groups.ResultsAfter nCPAP treatment,the treatment group,PaO2 was significantly higher（P〈0.01）,PaCO2 significantly reduced.On the probability of intubation,respiratory tract injury rate and re-intubation rate,pneumonia incidence rate associated breathing machine,the treatment group was significantly lower than the control group（P〈0.05）.On the cure rate,the two groups have no significant difference（P〈0.05）.ConclusionBased on the comprehensive treatment,nCPAP therapy is safe,effective,uncomplicated and can effectively reduce the risks that the breathing machine.