非侵入性呼吸道持续正压通气治疗新生儿呼吸衰竭的临床研究

A clinical study of noninvasive persistent positive pressure ventilation in treatment of neonatal respiratory failure

目的观察无创正爪通气（NPPV）治疗新牛儿呼吸衰竭（呼衰）的临床疗效。方法选择2010年1月至2011年12月入住本院新生儿重症监护病房（ICU）并给予NPPV辅助通气的106例呼衰新生儿，按给氧方式不同分为观察组（采用鼻塞NPPV治疗）53例，对照组（给予头罩口及氧）53例。治疗2h后比较两组的临床疗效及治疗前后动脉血气分析指标的变化。结果观察组总有效率明硅岛于对照组（83．0％比60．4％，P〈0．05）。两组治疗后动脉血氧分胝（PaO2，mmHg，1mm Hg=0．133kPa）和动脉血氧饱和度（SaO2）水平均较治疗前明显升高（均P〈0．05），且以观察组升高更显著（PaO2：78．34±20．08比53．46±11．43，SaO2：0．969±0．156比0．833±0．127，均P〈0．05），而两组pH值和动脉血二氧化碳分压（PaCO2，mm Hg）水平无明显变化（pH值：7．35±0．18比7．29±0．17，PaC02：38．50±11．20比42.48±11．80，均P〉0．05）．结论采用NPPV治疗新生儿呼衰能明显提高疗效，改善缺氧状态，值得临床推广应用。

Objective To observe the ~linieal effect of noninvasive positive pressure ventilation （NPPV） in treatment of neonatal respiratory failure. Methods From January 2010 to Dec, ember 2011, 106 cases admitted into the neonatal intensive care unit （ICU）with neonatal respiratory failure were randomly classified into two groups ： a observation group （53 cases） treated with NPPV and a control group （53 cases） treated with oxygen mask. After 2 hours of treatment, the changes of clinical effects and the indexes of arterial blood gas analyses were compared between the two groups. Results The total ett^ctive rate in observation group was significantly higher than that in control group （83.0% vs. 60.4%, P〈 0.05 ） . Compared with those before treatment, the arterial partial oxygen tension （PaO2, mm Hg, 1 mm Hg=0.133 kPa） and arterial oxygen saturation （SaO2） level were significantly increased after treatment （both P〈0.05）, the more significant improvement being in the observation group than those in control group（Pa02：78.34±20.08 vs. 53.46± 11.43, SAO2：0.969±0.156 vs. 0.833±0.127, both P〈0.05）, but no significant differences in pH and arterial partial carbon dioxide tension （PaCO：, mm Hg） between the two groups were seen after treatment （pH ： 7.35 ± 0.18 vs. 7.29 ± 0.17, PaCO2 ： 38.50 ± 11.20 vs. 42.48 ± 11.80, both P 〉 0.05 ） . Conclusion NPPV in treatment of neonatal respiratory failure can improve clinical effects and increase PaO2 and SaOe obviously, thus it can be used more extensively in the clinic.