经鼻持续气道正压通气治疗重症新生儿肺炎的效果及对患儿通气换气功能的影响

Effect of nasal continuous positive airway pressure in the treatment of severe neonatal pneumonia and its influence on ventilation and gas exchange function in children

目的探讨经鼻持续气道正压通气治疗重症新生儿肺炎的效果及对患儿通气及换气功能的影响。方法选取2013年12月至2018年6月我院收治的71例重症肺炎新生儿为研究对象,按照给氧方式的不同将其分为观察组(46例,经鼻持续气道正压通气治疗)与对照组(25例,鼻导管治疗),比较两组患儿的临床疗效。结果观察组患儿的治疗总有效率为93.48%,显著高于对照组的76.00%,差异具有统计学意义(P<0.05)。观察组患儿的呼吸困难消失时间、肺部啰音消失时间、血气指标恢复正常时间及住院时间均显著短于对照组,差异有统计学意义(P<0.05)。治疗后,两组患儿的PaCO2、PaO2、SaO2及pH较治疗前均明显改善,且观察组明显优于对照组(P<0.05)。治疗后,两组患儿的心率、呼吸频率及NCIS评分较治疗前均有明显改善,且观察组明显优于对照组(P<0.05)。结论经鼻持续气道正压通气治疗重症新生儿肺炎效果显著,可缩短患儿的呼吸困难消失时间、肺部啰音消失时间、血气指标恢复正常时间及住院时间,改善患儿血气指标、心率、呼吸频率及NCIS评分,值得推广与应用。

Objective To investigate the effect of nasal continuous positive airway pressure in the treatement of severe neonatal pneumonia and its inflnence on ventilation and gas exchange function in children.Methods Seventy-one neonatus with severe pneumonia admitted in our hospital from December 2013 to June 2018 were selected as the research objects and divided into observation group(46 cases,treated with nasal continuous positive airway pressure)and control group(25 cases,treated with nasal catheter)according to the different ways of oxygen supply.The clinical efficacy of the two groups was compared.Results The total effective rate of treatment was 93.48%in the observation group,which was significantly higher than 76.00%of the control group(P<0.05).The disappearance time of dyspnea,lung rale,time of blood gas indexes return to normal and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,PaCO2,PaO2,SaO2 and pH of the two groups improved significantly,and those in the observation group were significantly better than the control group(P<0.05).After treatment,the heart rate,respiratory trequenty and NCIS scores of the two groups improved significantly,and those in the observation group were significantly better than the control group(P<0.05).Conclusion Nasal continuous positive airway pressure is effective in the treatment of severe neonatal pneumonia.It can shorten the disappearance time of dyspnea,lung rale,time of blood gas indexes return to normal and hospitalization time,and improve the blood gas indexes,heart rate,respiratory rate and NCIS scores of children,which is worth popularizing and applying.