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目的探讨新生儿经鼻持续呼吸道正压通气(NCPAP)改良固定装置的临床应用。方法随机将370例使用NCPAP治疗的新生儿分为试验组184例与对照组186例。对照组使用原有NCPAP机配套的固定装置,试验组使用改良的固定装置。比较试验组和对照组新生儿使用后鼻部、皮肤的损伤情况,肺部并发症的发生率,颅内出血发生率,转换成呼吸机的发生率,通气时间,住院费用情况。结果试验组NCPAP总有效率(87.50%)显著高于对照组(68.28%)(P<0.01),试验组并发症发生率(8.70%)明显低于对照组(71.51%)。试验组鼻中隔损伤发生率为5.44%,头部皮肤损伤发生率为0.54%,气胸发生率为0,转换成呼吸机的比率为10.87%,机械通气时间为(120±43)h,住院费用为(13 370±4 346)元;对照组鼻中隔损伤发生率达26.34%,头部皮肤损伤发生率为5.38%,气胸发生率达15.10%,转换成呼吸机的比率为30.12%,机械通气时间为(166±39)h,住院费用为(17 408±3 376)元,2组比较差异均有统计学意义(Pa<0.05)。结论新生儿NCPAP改良固定装置能显著减少NCPAP并发症的发生率,减少机械通气时间及住院费用,方法简便且经济。
Objective To investigate the clinical application of nasal continuous positive airway pressure (NCPAP) device. Methods A total of 370 newborns treated with NCPAP were randomly divided into experimental group (184 cases) and control group (186 cases). The control group used the original fixed device of NCPAP machine, and the test group used the improved fixing device. The nasal and skin injury, the incidence of pulmonary complications, the incidence of intracranial hemorrhage, the incidence of ventilator conversion, ventilatory time and hospitalization expenses were compared between the experimental group and the control group after neonatal use. Results The total effective rate (87.50%) of experimental group was significantly higher than that of control group (68.28%) (P <0.01). The complication rate of experimental group was significantly lower than that of control group (8.70% vs 71.51%). The rate of nasal septum injury was 5.44%, the incidence of head skin injury was 0.54%, the rate of pneumothorax was 0, the rate of ventilator conversion to ventilator was 10.87%, the time of mechanical ventilation was (120 ± 43) h, the hospitalization cost was (13 370 ± 4 346). The incidence of nasal septum injury in control group was 26.34%, the incidence of head skin injury was 5.38%, the incidence of pneumothorax was 15.10%, the conversion rate to ventilator was 30.12%, the duration of mechanical ventilation was (166 ± 39) h, hospitalization cost was (17 408 ± 3 376) yuan, the difference between the two groups was statistically significant (Pa <0.05). Conclusion Neonatal NCPAP improved fixation device can significantly reduce the incidence of NCPAP complications, reduce the mechanical ventilation time and hospitalization costs, the method is simple and economical.