同步鼻塞式CPAP呼吸机在肺透明膜病早产儿中的临床应用  

Clinical application of synchronized nasal CPAP breathing machine in premature infants with hyaline membrane disease

作　　者：王依[1] 陈群娣[1] 

机构地区：[1]广东省博罗县人民医院儿科,516100

出　　处：《中国妇幼保健》2013年第10期1674-1676,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨在肺透明膜病(HMD)早产儿中应用同步鼻塞式持续正压通气(CPAP)呼吸机(NCPAP)的临床疗效。方法:选取2011年8月～2012年8月入住该院NICU确诊的HMD早产儿42例,按随机数字表分为观察组和对照组,每组21例,观察组给予肺表面活性物质(PS)+NCPAP治疗,对照组给予PS+有创机械通气(CMV)治疗,比较两组患儿治疗后效果。结果:两组患儿治疗前血气分析差异无统计学意义(P均>0.05)。治疗后1 h、12 h血气分析发现观察组优于对照组,观察组较对照组氧疗时间短(0.3±0.3)天,呼吸机相关性肺炎(VAP)发生率降低33.33%(7/21),呼吸机所致肺损伤(VI-LI)发生率降低33.33%(7/21),成功率高28.57%(6/21),经统计分析,差异均有统计学意义(P<0.05)。结论:NCPAP治疗HMD早产儿具有模仿生理呼吸同步性,氧耗减少,用氧时间缩短,治疗成功率明显提高,值得推广应用。Objective：To explore the clinical efficacy of synchronized nasal CPAP（NCPAP） breathing machine in premature infants with treatment of hyaline membrane disease（HMD）.Methods：A total of 42 cases with HMD from NICU of the hospital from August 2011 to August 2012 were selected,then they were divided into observation group and control group by random number table,21 cases in each group,the cases in observation group were treated with pulmonary surfactant（PS）＋NCPAP,the cases in control group were treated with PS＋CMV,the effects in the two groups after treatment were compared.Results：The blood gas analysis in the two groups showed that there was no significant difference before treatment（P0.05.）,at 1 hour and 12 hours after treatment,the blood gas analysis in observation group was better than that in control group,the oxygen therapy in observation group was shorter than that in control group by（0.3±0.3） days,the incidence of ventilator associated pneumonia（VAP） and ventilator-induced lung injury（VILI） in observation group decreased by 33.33%（7/21）,,and the successful rate in observation group was higher than that in control group by 28.57%（6/21）.After statistical analysis,the above-mentioned indexes had statistically significant differences.Conclusion：Synchronization nasal CPAP for treatment of HMD has synchronization of mimic physiological respiratory,which can reduce oxygen consumption and shorten with oxygen time.The successful rate increases significantly and the method id worthy to be popularized.

关 键 词：同步鼻塞式持续正压通气呼吸机 有创机械通气 肺表面活性物质 肺透明膜病 早产儿 

分 类 号：R722[医药卫生—儿科]