无创通气体位辅助装置在早产儿经鼻持续气道正压通气中的应用

Application of A Non-invasive Ventilation Positioning Device in Nasal Continuous Positive Airway Pressure in Premature Infants

目的探讨无创通气体位辅助装置在早产儿经鼻持续气道正压通气中的应用效果。方法采用方便抽样法,选择2019年1-12月在厦门市儿童医院新生儿重症监护室的早产儿作为研究对象,将2019年1-6月的223例早产儿设为对照组,将2019年7-12月的230例早产儿设为观察组。两组早产儿均使用新生儿双水平无创呼吸机行经鼻持续气道正压通气,体位摆放均由经培训的、从事新生儿护理工作5年以上的护士完成。对照组早产儿常规置于用棉布制成的椭圆形“鸟巢”中,观察组早产儿采用自制的无创通气体位辅助装置行体位固定。比较两组早产儿经鼻持续气道正压通气装置佩戴时间、经鼻持续气道正压通气使用时间、体位摆放规范率、鼻损伤发生率和日平均血氧饱和度波动次数。结果观察组早产儿经鼻持续气道正压通气装置佩戴时间、经鼻持续气道正压通气使用时间、日平均血氧饱和度波动次数、鼻损伤发生率均低于对照组(P<0.05),体位摆放规范率高于对照组(P<0.05)。结论无创通气体位辅助装置的应用提高了早产儿经鼻持续气道正压通气体位摆放规范率,保证有效通气,也提高了护理工作效率,降低了血氧饱和度波动次数及鼻损伤的发生率,值得临床推广应用。

Objective To investigate the effect of a non-invasive ventilation positioning device in nasal continuous positive airway pressure of premature infants.Methods The premature infants admitted to the NICU of Xiamen Children's Hospital from January to December 2019 were selected as the subjects by convenience sampling,with 223 cases from January to June 2019 included in the control group and 230 cases from July to December 2019 included in the observation group.Nasal continuous positive airway pressure was performed on the neonates in both group using a neonatal bi-level non-invasive ventilator,and those neonates were positioned by trained nurses with more than 5 years of experience in neonatal nursing.Premature infants in the control group were routinely placed in oval"bird nests"made of cotton cloth,while premature infants in the observation group were positioned using a self-made non-invasive ventilation positioning device.The wearing time of nasal continuous positive airway pressure ventilator,the use time of nasal continuous positive airway pressure,the compliance of body position,the incidence of nasal injury and the number of daily mean oxygen saturation fluctuations were compared between the two groups.Results The wearing time of nasal continuous positive airway pressure ventilator,the use time of nasal continuous positive airway pressure,the number of daily mean oxygen saturation fluctuations and the incidence of nasal injury in the observation group were lower than those in the control group(P<0.05),and the compliance of body position was higher than that in the control group(P<0.05).Conclusion The application of the non-invasive ventilation positioning device can improve the compliance of body position during nasal continuous positive airway pressure in premature infants,ensure effective ventilation and efficient nursing,and reduce the number of oxygen saturation fluctuations and the incidence of nasal injury.It is worthy of being widely popularized in clinical application.