持续气道正压通气治疗新生儿呼吸困难临床价值分析

Clinical value analysis of continuous positive airway pressure in treatment of neonatal dyspnea

目的研究持续气道正压通气治疗新生儿呼吸困难的临床价值。方法选择2011年2月至2013年1月高平市人民医院接诊的90例新生儿呼吸困难的患者进行研究。随机分为实验组和对照组两组。实验组患儿采用新型鼻塞CPAP仪对患儿进行持续气道正压通气进行治疗，对照组患儿采用头罩吸氧方式对患儿的呼吸状况进行改善。在治疗后，分别对两组患者在治疗后4h、1d及2d的O2、CO2分压情况、呼吸频率（RR）及氧合指数（OI）进行检测分析。并采用相关临床诊断标准对两组患者治疗的临床疗效及不良反应发生情况进行比较分析。结果实验组患者在治疗后1d、2d的动脉血氧分压（PaO2））明显高于对照组，两组比较差异有统计学意义（P〈0．01）。治疗后4h、1d及2d的患者的动脉血的CO2分压明显低于对照组，两组差异比较有统计学意义（P〈0．01）。治疗后1d及2d后，实验组患者的RR明显低于对照组，两组比较差异有统计学意义（P〈0．01）。实验组患者的0I明显高于对照组，两组比较差异有统计学意义（P〈0．01）。实验组患者治疗的临床总有效率（95．6％）明显高于对照组（75．6％），两组比较差异有统计学意义（X^2=7．5015，P=0．0235）。两组患者的不良反应发生情况差异无统计学意义（P〉0．05）。结论持续气道正压通气治疗新生儿呼吸困难临床价值较高，值得临床推广应用。

Objective To study the clinical value of continuous positive airway pressure treat-ment on neonatal dyspnea. Methods Ninety cases of neonatal dyspnea from February 2011 to January 2013 in the people＇ s hospital of Gaoping were studied. They were randomly divided into experimental group and control group. Patients in experimental group were treated with a new nasal CPAP device for children with continuous positive airway pressure treatment, and the patients in control group were treated with oxygen hood ways to improve children＇ s respiratory status. After treatment, patients in the treatment groups, respectively, after 4 h, 1 d and 2 d, O2, CO2 partial pressure conditions, respiratory rate（RR） and oxygenation index（OI） were detected and analyzed. And the clinical efficacy and adverse events of the patients in two groups were analyzed by clinical diagnostic criteria. Results In the experimental group after treatment, 1 d, 2 d of arterial oxygen tension （ PaO2 ） was significantly higher than those in the control group, there were significant differences（P 〈0.01 ）. After treatment, 4 h, 1 d and 2 d, the pa-tient＇ s arterial CO2 partial pressure was significantly lower than that in the control group, the differences were statistically significant（P 〈0. 01 ）. After treatment, 1 d and 2 d,the RR of the experimental group were significantly lower than that in the control group, the differences were statistically significant （P 〈 0. 01）. The OI of the experimental group was significantly higher than that in the control group, the differences was statistically significant（ P 〈 0.01 ）. The clinical total effective rate（95.6% ） of the exper- imental group was significantly higher than that in the control group（75.6% ）, the differences were sta- tistically significant（X^2 = 7. 5015, P = 0. 0235）. The incidence of adverse reactions of the two groups had no significant difference （P 〉 0. 05 ）. Conclusions The clinical value of the continuous positive air-way pressure treatment of neonatal dyspnea is good, and is worthy of clinical application.