鼻塞式CPAP对新生儿呼吸衰竭血气与血清CK-MB活性的影响

The effects of nose-stuffy CPAP on the blood gas analysis and serum CK-MB level in neonatal respiration failure

目的 探讨鼻塞式持续呼吸道正压 (CPAP)对新生儿呼吸衰竭的血气与血清肌酸激酶心型同工酶 (CK MB)活性的影响 ,以评价CPAP的临床应用价值。方法 对 4 5例呼吸衰竭新生儿采用鼻塞式CPAP给氧治疗 ,观察治疗后 1h血气改善及临床疗效情况和治疗 5d后血清CK MB活性变化。并与 4 0例头罩给氧的对照组比较。结果 治疗组CPAP后PaO2 和SaO2 较CPAP前明显升高 (P <0 0 1) ,pH和PaCO2 无明显变化 (P >0 0 5 )。氧疗前后PaO2 和SaO2 升高值治疗组较大 ,二组比较有显著差异 (P均 <0 0 5 ) ,pH升高值和PaCO2 下降值二组无显著性差异 (P均 >0 0 5 ) ,血清CK MB下降值治疗组较大 ,二组具有非常显著性差异 (P <0 0 1) ,且治疗组总有效率、存活率分别为 86 7%、88 9% ,明显高于对照组 5 5 %、6 7 5 % (P <0 0 1,0 0 5 )。结论 鼻塞式CPAP是治疗新生儿呼吸衰竭的有效方法 ,既能纠正严重低氧血症 ,又能减轻缺氧缺血性心脏损害 (HIM) 。

Objective To Study the effects of nose-stuffy continuous positive airway pressure (CPAP) on the blood gas analysis and serum creation kinase isozyme B (CK-MB) level in neonatal respiration failure,and evaluate the clinical value of CPAP.Methods 45 neonates with respiratory failure were treated with nose-stuffy CPAP oxygen.To observe the changes of blood gas,clinical effects after 1 hour and the changes of serum CK-MB after 5 days therapy,and 40 cases with face-guard Oxygen treatment were Compared.Results PaO\-2 and SaO\-2 after CPAP in treatment group were higher than that before CPAP (P<0.01),there were no obvious change in pH and PaCO\-2 (P>0.05).There were significant difference in PaO\-2 and SaO\-2 before and after Oxygen treatment between the two groups (P<0.05),the value of pH and PaCO\-2 had no significant difference (P>0.05)。The decreasing extent of serum CK-MB level was even higher in CPAP group than that in control group (P<0.01).The total validity rate and the survival rate in the treating group were 86\^7% and 88\^9%,they are higher than 55% and 67\^5% in the control group (P<0.01,0.05).Conclusion The nose-stuffy CPAP is an effective method to treat neonatal respiration failure,which can correct serious low-blood-oxygen symptom,reduce the hypoxic ischemic myocardopathy (HIM) and improve the prognosis.