摘要
目的观察经鼻持续正压通气(NCPAP)治疗新生儿肺透明膜病(HMD)的临床疗效。方法将76例HMD患儿随机分为两组,研究组39例给予NCPAP治疗,对照组37例给予常规机械通气治疗,比较两组治疗前后血氧分压(Pa O2)、二氧化碳分压(Pa CO2)的变化情况及呼吸机相关性肺炎、鼻黏膜损伤、氧疗时间、住院天数、治疗费用、治疗总有效率等。结果与治疗前相比较,两组患儿经治疗后Pa O2、Pa CO2均获得了显著改善(P<0.05)。两组治疗后各个时点的Pa O2、Pa CO2比较差异无统计学意义(P>0.05)。研究组呼吸机相关性肺炎、鼻黏膜损伤发生率和氧疗时间、住院天数、治疗费用明显低于或短于对照组(P<0.05)。研究组显效16例,有效21例,无效2例;对照组显效14例,有效20例,无效3例,两组比较差异无统计学意义(P>0.05)。结论 NCPAP与常规机械通气均能有效改善HMD患儿血气指标,但NCPAP能降低不良反应发生率,缩短氧疗时间和住院时间,减少治疗费用,是HMD较为安全、有效的治疗手段。
Objective To explore the clinical effect of nasal continuous positive airway pressure（ NCPAP）on hyaline membrane disease（ HMD） in neonates. Methods Seventy-six neonates with HMD were randomly divided into two groups. The research group（ n = 39） was treated with NCPAP,and the control group（ n = 37） was treated with the conventional mechanical ventilation. The changes of pappenheimer O_2,pappenheimer CO_2 and ventilator associated lung injury,nasal mucosal injury,oxygen therapy time,hospital stay,hospitalization costs,and total effective rate were compared between the two groups. Results Compared with those before the treatment,pappenheimer O_2 and pappenheimer CO_2 were significantly improved in both of the two groups after the treatment（ P〈0. 05）. There were no significant differences in the partial pressure of oxygen and pappenheimer CO_2 at all the time points after the treatment between the two groups（ P〉0. 05）. The incidences of complications such as ventilator associated lung injury and nasal mucosal injury in the research group were significantly lower than those in the control group（ P〈0. 05）.The oxygen therapy time,hospital stay and hospitalization costs in the research group were significantly less or lower than those in the control group（ P〈0. 05）. In the research group,16 cases were markedly effective,21 cases effective,2 cases invalid; In the control group,14 cases were markedly effective,20 cases effective,3 cases ineffective,with no significant difference betweent the two groups（ P〉0. 05）. Conclusion NCPAP has similar clinical effect to the conventional mechanical ventilation on HMD in neonates. However,nasal continuous positive airway pressure can reduce the incidence of complications and the hospitalization costs,shorten the time of the oxygen and hospital stay.
出处
《中国临床新医学》
2016年第7期612-615,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
鼻持续正压通气
常规机械通气
新生儿肺透明膜病
Nasal continuous positive airway pressure（NCPAP）
Conventional mechanical ventilation
Hyaline membrane disease（HMD）
