改良式通气管道固定法在新生儿经鼻持续气道正压通气中的应用探究

Application of modified ventilation tube fixation method innasal continuous positive airway pressure for neonates

目的探析改良通气管道固定法在新生儿经鼻持续气道正压通气(NCPAP)中的应用效果。方法选取2019年5月至2020年4月在中国科学技术大学附属第一医院新生儿科接受NCPAP治疗的80例患儿为研究对象,其中2019年5月至12月收治的40例患儿通气管道固定使用呼吸机配套固定帽固定(对照组),2020年1月至4月收治的40例患儿通气管道固定采用改良式固定法(研究组)。对比两组患儿每日睡眠时间、通气时间、相关并发症的发生率,并通过问卷调查了解科室护士对改良固定法的评价。结果研究组患儿的每日睡眠时间长于对照组[(17.52±1.08)h vs.(15.80±1.15)h],总通气时间短于对照组[(122.40±4.65)h vs.(168.32±5.77)h](均P<0.05);研究组的管道脱落、皮肤损伤及鼻中隔损伤的发生率(5.00%、2.50%、0%)均低于对照组(22.50%、10.00%、5.00%)(均P<0.05);问卷调查显示,科室护士均认为改良式固定法制作简单、效果良好,有助于提高患儿舒适度。结论在新生儿行NCPAP治疗中采用改良式通气管道固定法可有效延长患儿睡眠时间,缩短总通气时长,减少相关并发症的发生。

Objective To explore the effect of modified ventilation tube fixation in neonatal nasal continuous positive airway pressure(NCPAP).Methods Eighty neonates who were treated with NCPAP in the Department of Neonatology,the First Affiliated Hospital of University of Science and Technology of China from May 2019 to April 2020 were selected as the research subjects.Among them,40 neonates who were admitted from May to December 2019 were enrolled into control group where the fixed caps of the ventilator were used.And 40 cases who were admitted from January to April of 2020 were enrolled into study group where modified fixation methods applied.The daily sleep time,ventilation time,and the incidence of related complications were compared between the two groups of neonates.The evaluation of the improved fixation method was performed by questionnaire.Results The daily sleep time of neonates in the study group was longer than that of the control group([17.52±1.08]h vs.[15.80±1.15]h).And the total ventilation time was shorter than that of the control group([122.40±4.65]h vs.[168.32±5.77]h)(all P<0.05).The incidence of tube shedding,skin injury and nasal septum injury in the study group(5.00%,2.50%,0)were lower than those in the control group(22.50%,10.00%,5.00%)respectively(both P<0.05).The result of the survey showed that the nurses believed that the improved fixation method was simple and effective,which improved the comfortableness.Conclusions The application of modified ventilation tube fixation in neonatal NCPAP treatment can effectively prolong sleep time,shorten total ventilation time and reduce the occurrence of related complications.