经鼻高流量鼻导管湿化氧疗治疗新生儿肺炎合并呼吸衰竭的临床疗效

Study on the clinical effect of nasal high-flow catheter wet oxygen therapy in treatment of neonatal pneumonia complicated with respiratory failure

目的探讨经鼻高流量鼻导管湿化氧疗治疗新生儿肺炎合并呼吸衰竭的临床疗效。方法选取2015年9月-2016年11月进行治疗的新生儿肺炎合并呼吸衰竭患儿82例,按随机数字表将患儿分为对照组和观察组,每组各41例。对照组患儿采用经鼻持续正压通气治疗,观察组患儿采用经鼻高流量鼻导管湿化氧疗治疗。比较两组患儿症状消失时间、住院时间、血气分析指标、呼吸频率和疗效。结果观察组患儿的肺部啰音、三凹征、发绀、气促症状消失时间及住院时间均明显短于对照组患儿,差异均有统计学意义(P<0.05)。治疗前,两组患儿血气分析指标及呼吸频率比较差异均无统计学意义(P>0.05)。治疗后24 h,两组患儿血气分析指标及呼吸频率比较差异均无统计学意义(P>0.05)。治疗后24 h,两组患儿PaCO_2、PaO_2、呼吸频率较治疗前均有明显改善,差异均有统计学意义(P<0.05)。观察组患儿的治疗总有效率(95.1%)显著高于对照组患儿(75.6%),差异有统计学意义(χ~2=6.248,P<0.05)。结论经鼻高流量鼻导管湿化氧疗可提高治疗新生儿肺炎合并呼吸衰竭的效果,改善患儿血气分析结果,缩短临床症状消失时间,促进患者康复。

Objective To explore the clinical effect of nasal high-flow catheter wet oxygen therapy in treatment of neonatal pneumonia complicated with respiratory failure.Methods Eighty-two children with neonatal pneumonia complicated with respiratory failure treated in the hospital from September 2015 to November 2016 were selected and divided into control group and observation group according to random number table,41 children in each group.The children in control group were treated by nasal continuous positive pressure ventilation,and the children in observation group were treated by nasal high-flow catheter wet oxygen therapy.The disappearance time of symptoms,hospitalization time,indexes of blood gas analysis,respiratory rates and clinical effects in the two groups were compared.Results The disappearance time of lung rales,three-concave sign,cyanosis,anhelation and hospitalization time in observation group was statistically significantly shorter than that in control group（P〈0.05）.Before treatment,there was no statistically significant difference in indexes of blood gas analysis and respiratory rate between the two groups（P〈0.05）.At 24 hours after treatment,there was no statistically significant difference in indexes of blood gas analysis and respiratory rate between the two groups（P〈0.05）.At 24 hours after treatment,PaCO2,PaO2,and respiratory rates in the two groups were statistically significantly improved compared with before treatment（P〈0.05）.The total effective rate in observation group was 95.1%,which was statistically significantly higher than that in control group（75.6%）（χ^2= 6.248,P 0.05）.Conclusion Nasal high-flow catheter wet oxygen therapy can improve the treatment effect of neonatal pneumonia complicated with respiratory failure and blood gas analysis results,shorten the disappearance time of clinical symptoms,and promote recovery.