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目的探讨经鼻塞呼吸道正压给氧疗法(nCPAP)为主的综合治疗对新生儿呼吸衰竭的临床疗效。方法将110例呼吸衰竭新生儿随机分为治疗组和对照组,治疗组56例普通给氧无效换用nCPAP,无效者应用呼吸机,尽早撤机后再行nCPAP治疗;对照组54例,鼻导管与头罩吸氧无效者直接用呼吸机。检测治疗组用鼻导管吸氧与nCPAP两种治疗方法后其血气指标变化情况。结果治疗组经nCPAP治疗后,动脉氧分压(PaO2)显著升高(P<0.01),动脉二氧化碳分压(PaCO2)显著降低。观察组插管几率、呼吸道损伤率、再插管率、呼吸机相关性肺炎发生率均显著低于对照组(P<0.05);总治愈率与对照组比较差异无统计学意义(P>0.05)。结论在综合治疗的基础上,nCPAP疗法对新生儿呼吸衰竭的治疗安全有效,简便易行,可有效降低呼吸机应用的相关风险。
Objective To investigate the clinical effect of nasal obstruction positive respiratory oxygen therapy (nCPAP) -based comprehensive treatment on neonatal respiratory failure. Methods A total of 110 neonates with respiratory failure were randomly divided into treatment group and control group. In the treatment group, 56 patients were treated with nCPAP without ventilation and nCPAP was given to those who were ineffective. Catheters and hood oxygen inhalation directly with a ventilator. The changes of blood gas indexes of the treatment group after nasal catheter oxygen inhalation and nCPAP treatment were compared. Results After treatment with nCPAP, the arterial oxygen pressure (PaO2) was significantly increased (P <0.01) and the arterial carbon dioxide partial pressure (PaCO2) was significantly decreased. The incidence of intubation, respiratory injury, reintubation rate and ventilator-associated pneumonia in the observation group were significantly lower than those in the control group (P <0.05). There was no significant difference in the total cure rate between the two groups (P> 0.05 ). Conclusion On the basis of comprehensive treatment, nCPAP therapy is safe and effective for the treatment of neonatal respiratory failure, which is simple and easy to be implemented and can effectively reduce the risk associated with ventilator application.