经鼻间歇正压通气辅助呼吸治疗新生儿呼吸窘迫综合征疗效观察  

Curative effect of nasal intermittent positive pressure ventilation on neonatal respiratory distress syndrome

作　　者：陈春明[1] 关健强[1] 麦纪红 CHEN Chun-ming;GUAN Jian-qiang;MAI Ji-hong(Department of Pediatrics,Chang'an Hospital,Dongguan 523843,Guangdong,CHINA)

机构地区：[1]东莞市长安医院儿科,广东东莞523843

出　　处：《海南医学》2021年第8期999-1002,共4页Hainan Medical Journal

基　　金：广东省东莞市科技计划项目(编号:202050715022830)。

摘　　要：目的观察双鼻塞密闭环路方式经鼻间歇正压通气(NIPPV)辅助呼吸治疗新生儿呼吸窘迫综合征(NRDS)的临床效果。方法选择2016年2月至2020年2月东莞市长安医院收治的60例NRDS患儿进行研究,按照随机数表法分为观察组和对照组,每组30例。观察组在常规治疗基础上使用双鼻塞密闭环路方式NIPPV辅助通气治疗,对照组在常规治疗基础上使用经鼻持续气道正压通气(NCPAP)辅助通气治疗。比较两组患儿治疗3 d后的临床疗效、临床治疗情况,以及治疗前及治疗3 d后动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、呼吸频率(RR)、吸入氧浓度(FiO2)和并发症发生情况。结果治疗3 d后,观察组患儿的治疗总有效率为93.33%,明显高于对照组的73.33%,差异有统计学意义(P<0.05);观察组患儿的无创通气撤机时间、总用氧时间及住院时间分别为(3.06±0.34)d、(4.91±0.51)d、(14.20±2.64)d,明显短于对照组的(4.11±0.50)d、(6.26±0.64)d、(17.36±2.17)d,差异均有统计学意义(P<0.05);治疗3 d后,观察组患儿的PaO2为(78.45±5.62)mm Hg,明显高于对照组的(70.12±4.75)mm Hg,PaCO2、RR、Fi O2分别为(37.30±3.14)mm Hg、(45.73±4.69)次/min、0.26±0.03,明显低于对照组的(43.51±3.68)mm Hg、(53.08±5.03)次/min、0.31±0.03,差异均有统计学意义(P<0.05);观察组患儿的并发症总发生率为13.33%,明显低于对照组的36.67%,差异有统计学意义(P<0.05)。结论双鼻塞密闭环路NIPPV辅助呼吸治疗NRDS短期效果显著,其可明显缩短无创通气撤机时间、总用氧时间及住院时间,改善血气指标,减少并发症发生,值得推广应用。Objective To observe the clinical effect of nasal intermittent positive pressure ventilation(NIPPV)with double nasal closed loop in the treatment of neonatal respiratory distress syndrome(NRDS).Methods Sixty NRDS children in Dongguan Chang’an Hospital from February 2016 to February 2020 were selected and randomly divided into the observation group and the control group,with 30 patients in each group.The observation group was treated with NIPPV with double nasal closed loop on the basis of conventional treatment,and the control group was treated with nasal continuous positive airway pressure(NCPAP)on the basis of conventional treatment.The clinical efficacy at 3 days after treatment,general treatment outcome,the changes of the arterial oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2),respiratory frequency(RR),inspiratory oxygen concentration(FiO2)before and 3 days after treatment,as well as complications were compared between the two groups.Results After 3 days of treatment,the total effective rate of the observation group was 93.33%,which was significantly higher than 73.33%of the control group(P<0.05).The weaning time,total oxygen consumption time,and length of hospital stay in the observation group were(3.06±0.34)d,(4.91±0.51)d,(14.20±2.64)d,which were significantly shorter than(4.11±0.50)d,(6.26±0.64)d,(17.36±2.17)d of the control group(P<0.05).At 3 days after treatment,the PaCO2 in the observation group were(78.45±5.62)mmHg,which were significantly higher than(70.12±4.75)mmHg of the control group,and the PaCO2,RR,FiO2 were(37.30±3.14)mmHg,(45.73±4.69)time/min,0.26±0.03,which were significantly lower than(43.51±3.68)mmHg,(53.08±5.03)time/min,0.31±0.03 of the control group(P<0.05).The total incidence of complications in the observation group was 13.33%,which was significantly lower than 36.67%of the control group(P<0.05).Conclusion NIPPV with double nasal closed loop is effective in the treatment of neonatal NRDS,which can significantly shorten the weaning time,total oxygen c

关 键 词：新生儿呼吸窘迫综合征 经鼻间歇正压通气 双鼻塞密闭环路 经鼻持续气道正压通气 血气分析 并发症 

分 类 号：R722.1[医药卫生—儿科]