NCPAP序贯高流量鼻导管湿化氧疗治疗新生儿肺炎合并呼吸衰竭效果  

Effect of nasal continuous positive airway pressure sequential humidified high flow nasal cannula oxygen for treating neonates with pneumonia complicated with respiratory failure

作　　者：张元铭 梁玉兰[1] 杨盛泉[1] ZHANG Yuanming;LIANG Yulan;YANG Shengquan(Luzhou People's Hospital,Luzhou,Sichuan Province,646000)

机构地区：[1]四川省泸州市人民医院,646000

出　　处：《中国计划生育学杂志》2024年第3期563-567,572,共6页Chinese Journal of Family Planning

基　　金：四川省卫生和计划生育委员会课题(16PJ170)。

摘　　要：目的:探究经鼻持续气道正压通气(NCPAP)序贯高流量鼻导管湿化氧疗(HHFNC)治疗新生儿肺炎合并呼吸衰竭(RF)效果。方法:选取2019年1月-2023年3月本院接受治疗的肺炎合并RF新生儿102例,随机分为常规组(NCPAP序贯常规鼻导管吸氧治疗)和观察组(NCPAP序贯HHFNC治疗)各51例,比较两组治疗后临床症状消失时间,治疗24 h后血气指标、炎症因子水平、免疫功能。结果:治疗后临床症状消失时间观察组短于常规组;治疗24 h后,两组血氧分压、氧合指数及pH水平均升高且观察组(76.36±7.28 mmHg、204.75±20.15mmHg、7.25±0.59)均高于常规组(72.57±7.05mmHg、193.07±19.47mmHg、6.93±0.51),呼吸频率(51.43±3.67次/min)低于常规组(53.82±4.16次/min),两组炎症因子及免疫球蛋白水平均降低,且观察组C反应蛋白(9.25±1.06 mg/L)、中性粒细胞与淋巴细胞比值(1.22±0.31)、降钙素原(1.17±0.31 ng/L)均低于常规组(10.84±1.27 mg/L、1.48±0.36、1.41±0.45 ng/L)(均P<0.05)。结论:NCPAP序贯HHFNC可缩短肺炎合并RF新生儿临床症状改善时间,调节患儿血气指标及免疫功能,减轻炎症反应。Objective:To explore the effect of nasal continuous positive airway pressure(NCPAP)sequential humidified high flow nasal cannula(HHFNC)oxygen therapy for neonates with pneumonia complicated with respiratory failure(RF).Methods:102 neonates with pneumonia complicated with RF who wanted receiving the treatment in hospital were selected and were randomly divided into control group(51 neonates with the treatment of NCPAP sequential conventional nasal catheter oxygen therapy)and observation group(51 neonates with the treatment of NCPAP sequential HHFNC therapy)from January 2019 to March 2023.The disappearance time of the clinical symptoms,and the values of blood gas indicators,the inflammatory factors levels and the immune function after 24 hours of treatment of the neonates were compared between two groups.Results:The disappearance time of the clinical symptoms of the neonates in the observation group was significantly shorter than that of the neonates in the control group.After 24 hours of treatment,the values of the blood oxygen partial pressure,the oxygenation index and the pH of the neonates in the two groups had increased significantly,and which(76.36±7.28 mmHg,204.75±20.15mmHg and 7.25±0.59)of the neonates in the observation group were significantly higher than those(72.57±7.05mmHg,193.07±19.47mmHg and 6.93±0.51)of the neonates in the control group.The respiratory rate(51.43±3.67 times/min)of the neonates in the observation group was significantly lower than that(53.82±4.16 times/min)of the neonates in the control group.The levels of inflammatory factors and immunoglobulin of the neonates in the two groups had decreased significantly.The levels of C-reactive protein(9.25±1.06mg/L),neutrophil to lymphocyte ratio(1.22±0.31)and procalcitonin(1.17±0.31ng/L)of the neonates in the observation group were significantly lower than those(10.84±1.27 mg/L,1.48±0.36and 1.41±0.45ng/L)of the neonates in the conventional group(all P<0.05).Conclusion:NCPAP sequential HHFNC for treating the neonates with pneumonia

关 键 词：新生儿肺炎合并呼吸衰竭 经鼻持续气道正压通气 高流量鼻导管湿化氧疗 免疫功能 炎症因子 

分 类 号：R722.135[医药卫生—儿科]