鼻塞式持续气道正压通气在新生儿呼吸衰竭中的应用效果

Continuous Nasal Positive Airway Pressure Ventilation in Neonatal Respiratory Failure

目的探讨鼻塞式持续气道正压通气(NCPAP)在新生儿呼吸衰竭中的临床应用效果。方法选择该院2014年10月—2017年10月新生儿病房收治的350例新生儿呼吸衰竭患儿作为该次的研究对象。根据患儿不同的通气治疗方式,将其分为NCPAP组(50例)和常频机械通气(CMV)组(53例)。NCPAP组给予NCPAP治疗,CMV组给予CMV治疗。观察比较两组患儿的临床疗效,并对两组患儿治疗前及治疗后二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)及p H值变化进行比较,记录两组患儿在治疗期间呼吸机相关肺炎以及肺出血的发生情况。结果NCPAP组总有效率为86.00%,明显高于CMV组的73.59%,差异有统计学意义(χ~2=4.608,P<0.05)。治疗前两组患儿PaO_2、PaCO_2及p H值比较,均差异无统计学意义(t=0.369、0.148、1.429,P>0.05);治疗后,两组患儿的PaO_2、PaCO2及PH值均有明显改善,且NCPAP组改善效果显著优于CMV组,差异有统计学意义(t=41.661、13.361、18.107;t=37.481、8.046、8.139;t=7.408、6.321、13.487;P<0.05)。NCPAP组呼吸机相关性肺炎和肺出血发生率均显著低于对照组(8.00%vs 28.30%,6.00%vs 13.21%),差异有统计学意义(χ~2=4.545,P<0.05)。结论与CMV相比较,NCPAP治疗新生儿呼吸衰竭患儿的临床效果更佳,能有效的改善患儿的临床症状,减少并发症发生率,值得在临床上进行广泛的推广。

Objective This paper tries to explore the clinical effect of nasal congestion continuous positive airway pressure（NCPAP） in neonatal respiratory failure. Methods 350 children with neonatal respiratory failure who were admitted to the neonatal ward from October 2014 to October 2017 in this hospital were selected as subjects of this study. According to different ventilatory treatment methods of children, they were divided into NCPAP group（50 cases） and frequent mechanical ventilation（CMV） group（53 cases）. The NCPAP group was treated with NCPAP, and the CMV group was treated with CMV. Observe and compare the clinical curative effect of two groups of children, compare the changes of carbon dioxide partial pressure（PaCO2）, arterial oxygen partial pressure（PaO2） and p H value before and after treatment in two groups of children, record the two groups of children in treatment During ventilator-associated pneumonia and the occurrence of pulmonary hemorrhage. Results The total effective rate was 86.00% in the NCPAP group, which was significantly higher than the 73.59% in the CMV group. The difference was statistically significant（χ2=4.608,P〈0.05）. There was no significant difference in PaO2, PaCO2 and PH values between the two groups before treatment（t=0.369, 0.148, 1.429, P〉0.05）; after treatment, the PaO2, PaCO2 and PH values of the two groups were similar. There was significant improvement, and the improvement effect of NCPAP group was significantly better than that of CMV group（t=41.661, 13.361, 18.107; t=37.481, 8.046, 8.139; t=7.408, 6.321, 13.487;P〈0.05）. The incidence of ventilator-associated pneumonia and pulmonary hemorrhage in the NCPAP group was significantly lower than that in the control group（8.00% vs 28.30%, 6.00% vs 13.21%）, and the difference was statistically significant（χ2=4.545,P〈0.05）. Conclusion Compared with CMV, NCPAP has a better clinical effect on children with neonatal respiratory failure, can effectively improve the clinical symptoms of children, reduce the incidence of complications, and is worthy of extensive promotion in clinical practice.