血气监测指导对经鼻持续呼吸道正压给氧效果的影响  

作　　者：王冬妹[1] 曾亚丽 陈亚丽[1] 

机构地区：[1]汕头大学医学院附属粤北人民医院新生儿科,广东512026

出　　处：《当代医学》2015年第16期48-49,共2页Contemporary Medicine

摘　　要：目的探讨在血气监测指导下经鼻持续呼吸道正压给氧对肺源性呼吸困难新生儿肺功能的影响。方法选取肺源性呼吸困难新生儿共81例为研究对象,随机分为对照组(n=44)和观察组(n=37)。对照组给予头罩或鼻导管吸氧,无效者直接应用呼吸机。观察组给予头罩或鼻导管吸氧,无效者采用经鼻持续呼吸道正压给氧,并利用微量血气仪动态监测并调控,无效者应用呼吸机。比较2组患儿治疗前后动脉血二氧化碳分压(Pa CO2)、动脉血氧分压(Pa O2)、动脉血氧饱和度(Sa O2)及临床预后。结果治疗后,观察组患儿Pa O2、Sa O2、Pa CO2分别为(98.34±7.62)mm Hg、(98.95±4.56)%、(34.36±7.24)mm Hg,对照组分别为(87.61±7.65)mm Hg、(89.25±4.11)%、(43.53±6.89)mm Hg,组间比较差异有统计学意义(P<0.05)。观察组患儿治愈率显著高于对照组(86.5%vs 61.4%)(P<0.05);2组患儿上机率(8.1%vs 20.5%)及病死率(5.4%vs 18.2%)比较差异无统计学意义。结论在血气监测指导下经鼻持续呼吸道正压给氧可有效改善肺源性呼吸困难新生儿肺功能及预后。Objective To evaluate the effect of oxygen therapy with nasal continuous positive airway pressure under blood gas monitoring for pulmonary function of newborn with pulmonary dyspnea. Methods 81 newborn with pulmonary dyspnea as the research object, were randomly divided into control group(n=44) and observation group(n=37). The control group was given oxygen uptake through mask or nasal catheter, nullifier were treatment with breathing machine. Observation group was given oxygen uptake through mask or nasal catheter, nullifier were treatment with nasal continuous positive airway pressure, and used the trace blood gas meter dynamic to monitor and control, nullifier were treatment with breathing machine. The arterial blood CO2 partial pressure(Pa CO2), arterial blood oxygen partial pressure(Pa O2), blood oxygen saturation(Sa O2) and clinical prognosis were compared between the two groups. Results After treatment, the Pa O2, Sa O2 and Pa CO2 of observation group respectively was(98.34±7.62)mm Hg,(98.95±4.56)% and(34.36±7.24)mm Hg, those of control group respectively was(87.61±7.65)mm Hg,(89.25±4.11)% and(43.53±6.89)mm Hg, the difference showed statistically significant(P<0.05). The recovery rate of observation group were significantly higher than control group(86.5% vs 61.4%)(P<0.05). The rate of treated by breathing machine(8.1% vs 20.5%)and death(5.4% vs 18.2%)compared with two groups no statistical significance. Conclusion Oxygen therapy with nasal continuous positive airway pressure under blood gas can effectively improve pulmonary function and prognosis of pulmonary dyspnea newborn, worth wide use in the clinical.

关 键 词：肺源性呼吸困难 经鼻持续呼吸道正压通气 新生儿 

分 类 号：R473.72[医药卫生—护理学]