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目的探讨可变流量鼻罩持续气道正压(NCPAP)治疗新生儿肺透明膜病(HMD)的疗效。方法对42例HMD新生儿在综合治疗的基础上,予NCPAP通气治疗,其参数设定为流量6~8升/分,FiO20.4~0.6,压力为5~8cmH2O,观察患儿在NCPAP前、NC-PAP后6~8h、24h的临床及血气变化,比较PaO2及PaCO2的变化。结果42例患儿中有34例经NCPAP通气后呼吸困难和缺氧征有较明显的改善,血气PaO2明显提高(t=2.92,P<0.01),PaCO2也有一定程度下降;无发生气压伤及心血管并发症;治疗成功率80%。结论可变流量鼻罩NCPAP通气可改善通气及氧合,早期应用可避免气管插管,减少机械通气率,对新生儿HMD有较好的疗效。
Objective To investigate the efficacy of variable flow nasal mask continuous positive airway pressure (NCPAP) in the treatment of neonatal hyaline membrane disease (HMD). Methods Forty-two newborns with HMD were treated with NCPAP ventilation on the basis of comprehensive treatment. The parameters were set as flow rate of 6 to 8 liters / minute, FiO of 20.4 to 0.6 and pressure of 5 to 8 cmH2O. , Clinical and blood gas changes after 6 ~ 8h and 24h after NC-PAP, and the changes of PaO2 and PaCO2 were compared. Results Of the 42 children, dyspnea and hypoxia were significantly improved after NCPAP ventilation, blood gas PaO2 significantly increased (t = 2.92, P <0.01), and PaCO2 also decreased to a certain extent. No barotrauma occurred Cardiovascular complications; treatment success rate of 80%. Conclusion NCPAP ventilation with variable flow nasal mask can improve ventilation and oxygenation. Early application can avoid tracheal intubation, reduce mechanical ventilation rate, and have a good effect on neonatal HMD.