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目的回顾性的研究新型鼻塞持续气道正压(nCPAP)治疗新生儿严重低氧血症的疗效及安全性。方法以常规给氧无效的83例严重低氧血症患儿为研究对象,其中足月儿32例,早产儿51例。呼吸暂停33例,肺炎并呼吸衰竭(呼衰)21例,肺透明膜病19例,胎粪吸入综合征6例,新生儿湿肺4例。给予使用新型nCPAP治疗,观察治疗效果、并发症发生情况。结果给予nCPAP治疗后绝大多数患儿缺氧状态得到改善。治愈67例,16例效果不好转为气管插管行其他模式机械通气治疗。腹胀8例,心功能不全5例,鼻前庭皮肤部压迫伤2例,无一例发生气漏、慢性肺疾病和早产儿视网膜病。结论新型nCPAP治疗新生儿严重低氧血症操作方便,疗效满意,可以很好的控制温度和吸入氧的浓度,避免了因吸入纯氧、高浓度氧引起的视网膜病、慢性肺疾病等氧中毒性损伤。减少了气管插管的机会,降低了呼吸机相关性肺炎的发生率,相对比较安全。
Objective To retrospectively study the efficacy and safety of new nasal continuous positive airway pressure (nCPAP) in the treatment of neonatal severe hypoxemia. Methods Eighty-three children with severe hypoxemia who were ineffective with conventional oxygenation were enrolled. Among them, 32 were full-term infants and 51 were premature infants. 33 cases of apnea, pneumonia and respiratory failure (respiratory failure) in 21 cases, hyaline membrane disease in 19 cases, meconium aspiration syndrome in 6 cases, 4 cases of neonatal wet lungs. Given the use of new nCPAP treatment, observation of the treatment effect, the incidence of complications. Results The hypoxic condition was improved in the majority of children treated with nCPAP. Sixty-seven cases were cured and 16 cases failed to achieve the goal of mechanical ventilation in other modes of tracheal intubation. Abdominal distension in 8 cases, cardiac insufficiency in 5 cases, nasal vestibular skin pressure injury in 2 cases, no case of air leak, chronic lung disease and retinopathy of prematurity. Conclusion The new nCPAP treatment of neonatal severe hypoxemia easy to operate, with satisfactory results, can be well controlled temperature and inhaled oxygen concentration, to avoid inhalation of pure oxygen, high concentrations of oxygen-induced retinopathy, chronic lung disease and other oxygen Toxic injury. Reducing the chance of endotracheal intubation, reducing the incidence of ventilator-associated pneumonia, relatively safe.