鼻塞持续气道正压呼吸治疗新生儿呼吸衰竭的临床研究

Clinical study of continuous positive airway pressure in treatment for neonatal respiratory failure

目的观察鼻塞持续气道正压呼吸(CPAP)治疗新生儿呼吸衰竭的临床疗效。方法 106例呼吸衰竭新生儿随机分为两组,观察组53例采用CPAP治疗,对照组53例给予头罩吸氧,比较两组的临床疗效及治疗前后血气的变化。结果观察组的总有效率为79.2%,明显高于对照组的56.6%(P<0.05);观察组治疗后pH值为7.35±0.18,动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)分别为(10.42±2.67)、(6.22±1.59)kPa,动脉血氧饱和度(SaO2)为(96.85±15.58)%,而对照组pH值为(7.29±0.17),PaO2、PaCO2分别为(7.11±1.52)、(6.15±1.57)kPa,SaO2为(83.26±12.71)%;与治疗前比较,两组治疗后PaO2和SaO2水平明显升高(P<0.05),而pH值及PaCO2水平差异无统计学意义;观察组治疗后PaO2和SaO2水平明显高于同期对照组(P<0.05)。结论采用CPAP对呼吸衰竭新生儿进行治疗,能够明显提高疗效,改善缺氧状态。

OBJECTIVE To observe the clinical effect of continuous positive airway pressure（CPAP） by nasal facemask on treatment of neonatal respiratory failure.METHODS A total of 106 cases with neonatal respiratory failure were randomly classified into two groups,53 cases in control group were treated with oxygen mask and 53 cases in treatment group were treated with CPAP.The changes of clinical effect and blood gas between the two groups were compared.RESULTS The total effective rate in observation group was 79.2%,which was significantly higher than that in control group,56.6%（P〈0.05）.The level of pH,PaO2,PaCO2 and SaO2 was（7.35±0.18）,（10.42±2.67）,（6.22±1.59）,and（96.85±15.58）% in observation after treatment while was（7.29±0.17）,（7.11±1.52）kPa,（6.15±1.57）kPa and（83.26±12.71）% in control group.Compared with pre-treatment,the PaO2 and SaO2 was significantly increased（P〈0.05）after treatment but no significant differences in pH and PaCO2 in both two groups.Moreover,the levels of PaO2 and SaO2 in observation group after treatment were significantly higher than those in control group（P〈0.05）.CONCLUSION CPAP in treatment with neonatal respiratory failure can improve the clinical effect and increase PaO2 and SaO2,which is worthy of being promoted and applied in clinic.