新型经鼻持续气道正压通气优先策略治疗新生儿呼吸衰竭临床研究

Priority strategy of new nasal continuous positive airway pressure to treat neonatal respiratory failure

目的探讨新型经鼻持续气道正压通气（NCPAP）优先策略治疗新生儿呼吸衰竭的疗效。方法选择2006年1月至2008年1月采用简易水封瓶NCPAP治疗的新生儿呼吸衰竭50例为对照组;2008年2月至2010年6月采用新型NC-PAP治疗的新生儿呼吸衰竭60例为治疗组。治疗组入院后即应用新型NCPAP,对照组先应用头罩吸氧1~4 h,氧合不能改善改用简易水封瓶NCPCP。比较分析2组患儿NCPAP治疗成功率、NCPAP氧疗时间、肺气漏发生率及疗效。结果 NCPAP治疗成功率治疗组为85.0%,对照组为66.0%;NCPAP氧疗时间治疗组为（3.1±0.4）d,对照组为（4.3±0.5）d;肺气漏发生率治疗组为3.3%,对照组为4.0%;总有效率治疗组为86.7%,对照组为70.0%。2组NCPAP治疗成功率、氧疗时间、总有效率比较均有显著差异（P〈0.05）,治疗组肺气漏发生率较对照组略有降低,但2组间差异无显著性（P〉0.05）。结论实行新型NCPAP优先策略治疗新生儿呼吸衰竭可显著提高疗效,缩短氧疗时间,减少有创通气率。

Objective To explore the effect of a new nasal continuous positive airway pressure（NCPAP） which is priority strategic treatment for neonatal respiratory failure.Methods Fifty cases of neonatal respiratory failure in the control group were treated from January 2006 to January 2008 by using simple water seal bottle NCPAP;and 60 patients for the treatment group used the new NCPAP（Germany Stephan company,CPAP-B type） in the treatment of neonatal respiratory failure from February 2008 to June 2010.Group NCPAP was applied with new treatment after being admitted to hospital,the first application of oxygen hood 1 hr to 4hrs,the control group′s oxygenation did not improve by using of simple water seal bottle NCPCP.The results of the two groups of children were compared in terms of NCPAP treatment success rate,NCPAP oxygen therapy,the incidence of lung leak and efficacy.Results The success rate in treatment group with NCAPA was 85.0%,and that of control group was 66.0%;NCPAP oxygen therapy treatment group（3.1±0.4） d,the control group（4.3±0.5） d;lung leak rate of the treatment group was 3.3% in the control group was 4.0%;total effective rate was 86.7% in the treatment group and control group was 70.0%.NCPAP treatment success rate of the two groups,oxygen therapy,there were significant differences in efficiency（P0.05） of treatment group,the incidence of lung leak slightly lower than the control group,but the difference between the two groups was not significant（P0.05）.Conclusion The first strategy to implement the new NCPAP treatment of neonatal respiratory failure could significantly improve the efficacy and reduce the oxygen therapy to reduce the rate of invasive ventilation.