鼻持续气道正压通气联合俯卧位治疗早产儿反复呼吸暂停

Nasal Continuous Positive Airway Pressure Combined with Prone Position in Treatment Premature Infants with Repeated Apnea

目的探讨经鼻持续气道正压通气联合俯卧位治疗早产儿反复呼吸暂停的临床疗效。方法选取2016年6月至2017年5月收住我院的反复呼吸暂停患儿90例,均接受经鼻持续气道正压通气治疗。其中俯卧位45例为观察组,仰卧位45例为对照组。记录血气分析指标,比较两组临床疗效。结果两组均顺利完成治疗,治疗期间无死亡病例。观察组有效率93.33%(42/45)优于对照组的73.33%(33/45)(Z=-2.183,P<0.05)。治疗前两组动脉血CO_2分压(PaCO_2)、动脉血氧分压(PaO_2)、氧合指数(PaO_2/FiO_2)、呼气末正压(PEEP)、吸入氧浓度(FiO_2)均无统计学差异(均P>0.05);治疗后两组PEEP和FiO_2无明显变化(均P>0.05),但观察组PaO_2、PaO_2/FiO_2较对照组升高(均P<0.05),而PaCO_2较对照组降低(P<0.05)。结论对反复呼吸暂停早产儿,采用经鼻持续气道正压通气联合俯卧位,可有效改善氧合指标,提高临床疗效。

Objective To investigate the clinical efficacy of nasal continuous positive airway pressure combined with prone position in treatment premature infants with repeated apnea. Methods 90 cases of repeated apnea in our hospital were selected from June 2016 to May 2017,and all received nasal continuous positive airway pressure treatment.The prone position in 45 cases was the observation group,and supine position in 45 cases as the control group.The clinical efficacy of the two groups was compared,and the blood gas analysis indexes were recorded. Results All patients completed the treatment successfully without death cases during the treatment.The effective rate of the observation group 93.33%(42/45)was better than that of the control group 73.33%(33/45)(Z=-2.183,P<0.05).The PaCO 2,PaO 2,PaO 2/FiO 2,PEEP and FiO 2 were not statistically different between the two groups before treatment(all P>0.05).After treatment,there were no significant changes in PEEP and FiO 2 in the two groups(all P>0.05),but the PaO 2 and PaO 2/FiO 2 in the observation group were higher than that of control group(all P<0.05),and PaCO 2 was lower than that of control group(P<0.05).Conclusion Nasal continuous positive airway pressure combined with prone position could effectively improve the oxygenation index and clinical efficacy in premature infants with repeated apnea.