早期经鼻持续气道正压通气治疗新生儿呼吸窘迫综合征的效果及对早产儿肺功能的影响

Effect of early-stage nasal continuous positive airway pressure in the treatment of neonatal respiratory distress syndrome and its influence on pulmonary function in premature infants

目的：探讨早期经鼻持续气道正压通气治疗新生儿呼吸窘迫综合征的效果及对早产儿肺功能的影响。方法选取本院2011年4月-2014年7月收治的114例产后呼吸窘迫综合征新生儿为研究对象,根据其分娩顺序分为常规头罩吸氧组（A组,n=49）和经鼻持续气道正压通气组（B组,n=65）。比较两组患儿治疗前后肺泡氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、氧合指数（OI）等呼吸指标的变化差异,记录其转归情况。结果两组患儿通气72 h后,PaO2及OI均较治疗前明显提高,PaCO2显著降低（P〈0.05）；其中B组变化幅度大于A组（P〈0.05）。两组患儿的死亡率及相关并发症发生率比较,差异无统计学意义（P〉0.05）；B组通气持续时间、住院时间短于A组,中途转有创通气率低于A组,差异有统计学意义（P〈0.05）。结论对产后出现呼吸窘迫综合征的新生儿给予早期经鼻持续气道正压通气方案,疗效确切,可降低其相关并发症发生风险,值得临床推广。

Objective To explore the effect of early-stage nasal continuous positive airway pressure （NCPAP） in the treatment of neonatal respiratory distress syndrome （NRDS） and its influence on pulmonary function in premature infants. Methods 114 premature infants with NRDS treated in our hospital from April 2011 to July 2014 were selected as re-search objects,and were divided into regular head-mask oxygen inhalation group （group A,n=49） and NCPAP group （group B,n=65） according to delivery sequence.The changes of alveolar oxygen partial pressure （PaO2）,arterial carbon dioxide tension （PaCO2）,oxygenation index （OI） before and after treatment was observed and prognosis was recorded. Results After 72-hour ventilation,PaO2 and OI of two groups improved compared with prior treatment,while PaCO2 de-creased （P〈0.05）;The amplitude of variation in group B was larger than that in group A （P〈0.05）.There was no signifi-cant difference in mortality or incidence of the related complications （P〉0.05）.The continuous ventilation time,hospital stay of group B was shorter than that of group A,and mid-way invasive ventilation rate was lower than that of group A （P〈0.05）. Conclusion For newborns with respiratory distress syndrome after delivery,NCPAP obtains a definite effect and can decrease the risks of related complications,which is worthy of clinical expansion.