持续气道正压通气治疗儿童呼吸衰竭的疗效观察

Curative effect of continuous positive airway pressure on children with respiratory failure

目的探讨鼻塞式持续气道正压通气(CPAP)治疗儿童呼吸衰竭的疗效。方法 42例不同原因引起的呼吸衰竭患儿使用常规氧疗、鼻塞式CPAP及呼吸机进行治疗,比较治疗前后的临床情况(气喘、气促、三凹征)、动脉血气[pH、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)]的变化及住院时间、预后等。结果常规氧疗有效率为50%,CPAP有效率为79%,呼吸机有效率为100%。住院时间CPAP组为8.9 d,较常规氧疗(12.5 d)和呼吸机治疗(12.7 d)均明显缩短(P<0.05)。结论鼻塞式CPAP治疗儿童呼吸衰竭疗效显著,可以减少有创通气的应用及缩短住院时间,避免了有创呼吸支持对儿童气道的损害,具有无创伤、易操作、低费用、高疗效等优点,值得推广应用。

Objective To investigate the curative effect of nasal continuous positive airway pressure（NCPAP）on children with respiratory failure. Methods Forty-two children with respiratory failure caused by different reasons,were treated with gen-eral oxygen treatment,NCPAP and the ventilator. The clinical situations（ asthma,shortness of breath,and three depression sign）,the changes of arterial blood gas analysis（pH,and PaO2 ,and PaCO2 ）,the hospital stays and prognosis before and after treatment were compared. Results The effective rate of conventional oxygen therapy was 50% ,CPAP was 79% ,ventilator was 100% . The hospital stay was 8. 9 days in CPAP group,which was significantly shorter than that in conventional oxygen therapy group（12. 5 days）and ventilator therapy group（12. 7 days）（P 〈 0. 05）. Conclusion NCPAP in treatment of children with re-spiratory failure can significantly reduce the invasive ventilation applications,shorten hospital stays,and avoid invasive respirato-ry support for children′s airway damage. It is non-invasive,easy to operate,and has the advantages of low cost,high efficacy. It is worthy of promotion.