经鼻持续气道正压通气与头罩/鼻导管吸氧治疗重症新生儿肺炎的临床疗效  

Clinical efficacy of nasal continuous positive airway pressure ventilation and headmask/nasal catheter oxygen inhalation in the treatment of severe neonatal pneumonia

作　　者：杜海燕 孙亚凯 刘波 卢会娟 DU Hai-yan;SUN Ya-kai;LIU Bo;LU Hui-juan(Department of Neonatology,Ruzhou First People's Hospital,Ruzhou 467500,Henan,CHINA;Children's Rehabilitation Department,Ruzhou First People's Hospital)

机构地区：[1]汝州市第一人民医院新生儿科,河南汝州467500 [2]汝州市第一人民医院儿童康复科,河南汝州467500

出　　处：《海南医学》2023年第16期2357-2361,共5页Hainan Medical Journal

基　　金：中原科技创业领军人才项目(编号:224400610007)。

摘　　要：目的比较经鼻持续气道正压通气(CPAP)与头罩/鼻导管吸氧治疗重症新生儿肺炎(SNP)的临床疗效,并探讨其对患儿呼吸功能、心功能、血气指标和并发症的影响。方法选取2021年1月1日至2022年8月31日汝州市第一人民医院收治的66例SNP患儿作为研究对象,按随机数表法分为常规吸氧组和CPAP组各33例。两组患儿均给予常规的对症支持治疗,常规吸氧组患儿同时采用头罩/鼻导管吸氧治疗,CPAP组患儿则采用经鼻CPAP治疗。治疗7 d后,比较两组患儿的治疗总有效率,以及治疗前后的呼吸功能指标[呼气峰流速(PEF)、25%肺活量时的用力呼气流速(TEF25%)、功能残气量(FRC)]、心功能指标[左室射血分数(LVEF)、房室瓣E与A峰比值(E/A)、心脏指数(CI)]、血气分析指标[动脉的血氧分压(PaO_(2))、动脉的血二氧化碳分压(PaCO_(2))、氧合指数(OI)]和并发症发生情况。结果治疗7 d后,CPAP组患儿的治疗总有效率为93.94%,明显高于常规吸氧组的75.76%,差异有统计学意义(P<0.05);治疗1 d、3 d、7 d后,CPAP组患儿的PEF、TEF25%、FRC、LVEF、E/A、CI、PaO_(2)、OI明显高于常规吸氧组,PaCO_(2)明显低于常规吸氧组,差异均具有统计学意义(P<0.05);CPAP组患儿的并发症总发生率为6.06%,明显低于常规吸氧组的27.27%,差异具有统计学意义(P<0.05)。结论与头罩/鼻导管吸氧比较,经鼻CPAP治疗SNP的疗效更加显著,能进一步改善患儿的呼吸功能、心功能和血气指标,有助于患儿快速康复,且并发症较少,安全性更高。Objective To compare the clinical effect of nasal continuous positive airway pressure(CPAP)ventilation and headmask/nasal catheter oxygen inhalation in the treatment of severe neonatal pneumonia(SNP)and investigate its influence on the respiratory function,cardiac function,blood gas index,and complications of children.Methods Sixty-six patients of SNP admitted to Ruzhou First People's Hospital from January 1,2021 to August 31,2022 were selected.According to random number table method,they were divided into conventional oxygen inhalation group and CPAP group,with 33 patients in each group.Based on routine symptomatic support treatment,the conventional oxygen inhalation group was treated with oxygen inhalation through head mask/nasal catheter,and the CPAP group was treated with nasal CPAP.The total effective rate after 7 days of treatment,respiratory function indexes[peak expiratory flow rate(PEF),forced expiratory flow rate at 25%vital capacity(TEF25%),functional residual volume(FRC)],cardiac function indexes[left ventricular ejection fraction(LVEF),ratio of atrioventricular valve E to peak A(E/A),cardiac index(CI)],blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(OI)]before and after the treatment,and complications were compared between the two groups.Results After 7 days of treatment,the total effective rate of CPAP group was 93.94%,which was significantly higher than 75.76% of conventional oxygen inhalation group(P<0.05).After 1 day,3 days,and 7 days of treatment,PEF,TEF25%,FRC,LVEF,E/A,CI,PaO_(2),OI in CPAP group were significantly higher than those in the conventional oxygen inhalation group,and PaCO_(2) in CPAP group was significantly lower,with statistically significant difference(P<0.05).The complication rate of CPAP group was 6.06%,which was significantly lower than 27.27% of conventional oxygen inhalation group(P<0.05).Conclusion Compared with the mask/nasal catheter oxygen inhalation,nasal CPAP is more effecti

关 键 词：重症新生儿肺炎 经鼻持续气道正压通气 呼吸功能 心功能 血气指标 

分 类 号：R722[医药卫生—儿科]