鼻塞式持续正压通气救治新生儿呼吸困难的临床效果及对呼吸功能、血气指标及转运的影响

Clinical Effect of Nasal Continuous Positive Pressure Ventilation on Neonatal Dyspnea and Effect on Respiratory Function,Blood Gas Index and Transport

目的研究分析鼻塞式持续正压通气救治新生儿呼吸困难的临床效果、对呼吸功能、血气指标及转运的影响。方法将2019年6月-2020年12月在本院接受治疗的90例新生儿呼吸困难患儿作为研究对象,随机将患儿分为研究组和对照组,每组45例。其中,对照组患儿给予常规机械通气,研究组患儿给予鼻塞式持续正压通气治疗。对比两组患儿的治疗效果、呼吸功能相关指标以及治疗前后血气指标变化。结果研究组患儿的治疗总有效率93.33%显著高于对照组75.56%,差异有统计学意义(P<0.05)。治疗后,两组患儿氧合指数(OI)、吸气氧浓度分数(FiO_(2))均下降,且研究组显著低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组动脉血氧分压(PaO_(2))和pH水平显著高于对照组,动脉血二氧化碳分压(PaCO_(2))水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组IgG、IgA及IgM对比(P>0.05);治疗后,研究组IgG、IgA及IgM水平高于对照组,差异有统计学意义(P<0.05)。对照组并发症总发生率20.00%较研究组4.44%降低了15.56%,差异有统计学意义(P<0.05)。结论将鼻塞式持续正压通气应用于新生儿呼吸困难的治疗,有显著的临床疗效,明显改善患儿的呼吸功能和血气状态,并有利于调节新生儿免疫功能继而可降低并发症发生风险,在临床应用中兼具有效性及安全性,值得在临床实践中推广。

Objective To study and analyze clinical effect of nasal continuous positive pressure ventilation on neonatal dyspnea and influence on respiratory function,blood gas index and transport.Methods The paper chose 90 neonates with dyspnea treated in our hospital from June 2019 to December 2020 as research objects,and divided them into study group and control group randomly,with 45 cases in each group.Control group was treated with routine mechanical ventilation,and study group with nasal continuous positive pressure ventilation.Curative effect,respiratory function and blood gas indexes before and after treatment were compared between two groups.Results Total effective rate of 93.33%in study group was significantly higher than 75.56%in control group(P<0.05).After treatment,oxygenation index(OI)and inspiratory oxygen concentration fraction(FiO_(2))of two groups decreased,that of study group was significantly lower than control group,with statistically significant difference(P<0.05).After treatment,arterial partial pressure of oxygen(PaO_(2))and pH in study group was significantly higher than control group,while arterial partial pressure of carbon dioxide(PaCO_(2))was lower than control group,with statistically significant difference(P<0.05).Before treatment,IgG,IgA and IgM comparison between two groups showed(P>0.05).After treatment,levels of IgG,IgA and IgM in study group were significantly higher than control group(P<0.05).Total incidence of complications in control group was 20.00%,which was 15.56%lower than study group,difference was statistically significant,(4.44%,P<0.05).Conclusion Nasal continuous positive pressure ventilation can achieve significant clinical effect in treatment of neonatal dyspnea,improve respiratory function and blood gas status of children significantly,help regulate immune function of neonates,reduce risks of complications,which is effective and safe in clinical application,and worthy of promotion in clinical practice.