新生儿鼻塞持续气道正压通气压力稳定性的影响因素分析

Influence factor analysis of nasal continuous positive airway pressure stability for newborn

目的探讨新生儿鼻塞持续气道正压通气(NCPAP)压力稳定性的影响因素,为提高NCPAP质量提供数据支撑。方法回顾性分析本院收治的223例新生儿呼吸窘迫综合征患者的临床资料,所有患儿均行NCPAP治疗,根据NCPAP压力异常次数分为≥3次组和<3次组,采用统计学软件SPSS 19.0分析NCPAP压力异常的影响因素和危险因素。结果本组患儿共发生NCPAP压力异常602次,平均每位患儿2.7次,出生体质量(t=2.601,P=0.040)、NCPAP使用时间(t=14.217,P<0.001)、鼻塞脱落(χ~2=12.043,P=0.001)、鼻黏膜损伤(χ~2=11.314,P=0.001)、胎儿躁动(χ~2=4.814,P=0.028)、管路漏气(χ~2=4.332,P=0.037)、分泌物堵塞气道(χ~2=6.789,P=0.009)和管路冷凝水过多(χ~2=5.026,P=0.025)均为NCPAP压力稳定性的影响因素,其中NCPAP使用时间≥72 h(OR=2.159,95%CI:1.212~8.874)、鼻塞脱落(OR=3.283,95%CI:1.643~6.558)、鼻黏膜损伤(OR=2.724,95%CI:1.506~1.930)、胎儿躁动(OR=1.873,95%CI:1.066~3.291)、分泌物阻塞管道(OR=2.419,95%CI:1.231~4.755)及管路冷凝水过多(OR=2.253,95%CI:1.095~4.637)是导致NCPAP压力异常的危险因素。结论根据NCPAP压力异常的危险因素采取必要的预防措施,并及时排查故障是提高NCPAP质量的有效措施。

Objective To explore the influence factors of nasal continuous positive airway pressure （NCPAP） stability for newborn, so as to provide data evidence to promote NCPAP quality. Methods The clinical data of totally 223 cases of neonatal respiratory distress syndrome was analyzed, and all the patients were treated with NCPAP and divided into 2 groups according to pressure anomaly time： ≥3 times group and 〈3 times group. SPSS19.0 was used to analyze the influence factors and risk factors of pressure anomaly. Results There was 602 times pressure anomaly in total, and 2.7 times per child. The birth body mass （t=2. 601, P=0.040）, NCPAP use time （t= 14. 217, P〈0.001）, stuffy nose off （χ^2=12. 043, P=0.001）, nasal mucosa damage （χ^2= 11. 314, P=0.001 ）, fetus restless （χ^2 =4. 814, P=0.028）, pipe line leakage （χ^2 =4. 332, P=0. 037）, secreta block （χ^2 =6. 789, P=0. 009） and excessive condensate water （χ^2 = 5. 026, P=0.025） were all influence factors for NCPAP stability. NCPAP≥72（OR= 2. 159,95% CI： l. 212 ～8. 874）, stuffy nose off（ OR= 3. 283,95% CI： 1. 643 ～ 6. 558）, nasal mucosa damage （ OR = 2. 724,95 % CI： 1. 506 ～ 1. 930 ）, fetus restless （ OR = 1. 873,95 % CI： 1. 066～ 3.291 ）, secreta block （ OR = 2. 419,95 % CI： 1.231 ～ 4.755 ） and excessive condensate water （ OR = 2. 253, 95 % CI： 1. 095～4. 637 ） were also risk factors for NCPAP pressure anomaly. Conclusion Necessary precautions should be taken according to the risk factors of NCPAP pressure anomaly, and timely troubleshooting is the effective measure for improving NCPAP quality.