N-CPAP在早产儿RDS及新生儿呼吸衰竭中的临床应用

CLINICAL APPLICATION OF N - CPAP IN PRETERM INFANT RDS AND NEONATAL RESPIRATORY FAILURE

为探讨经鼻塞持续气道正压通气(N-CPAP)治疗早产儿呼吸窘迫综合征(RDS)及新生儿呼吸衰竭的效果,采用带有空氧混合器、加温湿化器的N-CPAP氧疗器对21例危重新生儿进行经鼻塞持续气道正压通气治疗,观察治疗前后临床症状、胸片及呼吸功能各指标的变化。结果:早产儿RDS应用N-CPAP后动脉血氧分压(PaO_2)由(42±4)升至(88±7)mmHg(P<0.01);动脉二氧化碳分压(PaCO_2)由(63.5±7.1)降至(38.2±4.9)mmHg(P<0.01);氧合指数(PaO_2/FiO_2)由(42±4)升至(420±58)mmHg(P<0.01);肺内分流量(Q_S/Q_T)由治疗初的(26.6%±3.1%)降至(5.4％±0.6%)、(1.5％±0.3％)(P<0.1)。N-CPAP治疗新生儿肺炎、先天性喉喘鸣合并呼吸衰竭及早产儿原发性呼吸暂停均有较好疗效。结果提示带空氧混合器、加温湿化器的N-CPAP治疗早产儿RDS及新生儿呼吸衰竭效果显著。是基层医院新生儿科的一种简便易行、无创安全、经济且疗效显著呼吸支持设备。

Objective To explore the effect of N - CPAP treatment on preterm infant RDS and neonatal respiratory failure. Methods N - CPAP device with ari - oxygen mixture instrument and thermohydrophic pot was used in 21 critical newborns, the variation of clinics, chest radiograph and the index of respiratory function were monitored. Results After using N - CPAP device, all cases got improvement in dyspnea and anoxia, RDS cases have increment of PaO2[(42±4) vs (88±7), P<0.0l], decrement of PaCO2 [(63.5±7.1) vs (38.2±4.9), P<0.01], their oxygenation(PaO2/FiO2) improved[(42 ± 4) vs (420±58), P<0.01], and intrapulmonary shunt(Qs/Qt) reduced [(26.6±3.1)% vs (1.5±0. 3) %, P < 0.01 ]. Conclusion N - CPAP is effective in treatment of neonatal respiratory failure and RDS. The device, with air- oxygen mixture instrument and thermohydrophic pot, is safe, economic and effective.