连续气道正压通气联合精细护理在新生儿呼吸窘迫综合征患儿中的应用效果  

Application effect of non-invasive continuous positive airway pressure combined with meticulous nursing on children with neonatal respiratory distress syndrome

作　　者：张小雯 刘彦彦 ZHANG Xiaowen;LIU Yanyan(Department of Neonatology,Yichun Maternal and Child Health Care Hospital,Jiangxi Province,Yichun 336000,China)

机构地区：[1]江西省宜春市妇幼保健院新生儿科,江西宜春336000

出　　处：《中国当代医药》2023年第15期176-179,184,共5页China Modern Medicine

基　　金：江西省宜春市科技计划项目(2022ZDJH6045)。

摘　　要：目的探讨连续气道正压通气(CPAP)联合精细护理对新生儿呼吸窘迫综合征(NRDS)患儿治疗效果及安全性的影响。方法回顾性分析宜春市妇幼保健院新生儿科2021年6月至2022年5月收治的72例NRDS早产儿资料,将2021年6月至2021年11月接受CPAP治疗联合常规护理的NRDS患儿设为对照组,将2021年12月至2022年5月接受CPAP呼吸机联合精细化护理的NRDS患儿设为观察组,经过倾向性匹配评分法排除混杂因素,最终两组各纳入36例患儿,比较两组患儿症状恢复时间,干预前、干预7 d后血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、PaO_(2)/吸入氧浓度百分比(FiO_(2))、血氧饱和度(SaO_(2))]、肺功能情况[一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC值]及并发症发生情况。结果观察组患儿呼吸困难、肺部啰音、发绀的消失时间和住院时间均短于对照组,差异有统计学意义(P<0.05);观察组患儿干预7 d后的SaO_(2)、PaO_(2)、PaO_(2)/FiO_(2)均高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05);观察组患儿干预7 d后的FEV_(1)、FVC及FEV_(1)/FVC均高于对照组,差异有统计学意义(P<0.05);观察组患儿护理期间的呼吸机相关并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论将精细护理应用于NRDS患儿CPAP呼吸机治疗,可明显提升治疗效果,改善肺功能及氧合指标,减少并发症发生,值得进一步推广。Objective To explore the influence of non-invasive continuous positive airway pressure(CPAP)combined with meticulous nursing on the therapeutic effect and safety of neonatal respiratory distress syndrome(NRDS)in children.Methods The data of premature infants with NRDS treated in Department of Neonatology of Yichun Maternal and Child Health Care Hospital were retrospectively analyzed between June 2021 and May 2022.Children with NRDS who received CPAP treatment from June 2021 to November 2021 were set as control group and received routine nursing,and children with NRDS who underwent CPAP combined with meticulous nursing from December 2021 to May 2022 were enrolled as observation group.Confounding factors were excluded by propensity matching scoring method,thus each 36 cases were finally obtained in the two groups.The symptom recovery time,blood gas indicators(arterial partial pressure of oxygen[PaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)],percentage of PaO_(2)/fraction of inspired oxygen[FiO_(2)],oxygen saturation[SaO_(2)]),pulmonary function(forced expiratory volume in one second[FEV_(1)],forced vital capacity[FVC],FEV_(1)/FVC)before and after 7 d of intervention and occurrence of complications were compared between the two groups.Results The disappearance times of dyspnea,pulmonary rales,cyanosis and hospital stay of children in observation group were shorter than those in control group,the differences were statistically significant(P<0.05).After 7 d of intervention,the SaO_(2),PaO_(2) and PaO_(2)/FiO_(2) in observation group were higher than those of control group,while the PaCO_(2) was lower than that of control group,the differences were statistically significant(P<0.05).The FEV_(1),FVC and FEV_(1)/FVC of children in observation group were higher compared with those in control group after 7 d of intervention,the differences were statistically significant(P<0.05).The incidence rates of ventilator-related complications in observation group during nursing were lower than those in control group,t

关 键 词：连续气道正压通气 精细护理 新生儿呼吸窘迫综合征 安全性 

分 类 号：R473.72[医药卫生—护理学]