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目的 :评价鼻塞气道正压通气 (CPAP)对小儿心脏术后急性呼吸衰竭的治疗作用。 方法 :18例心脏术后合并急性呼吸衰竭患儿 ,年龄 9个月～ 6岁 ,观察 CPAP前后血压、心率、呼吸频率及动脉血气的变化。 结果 :与 CPAP应用前相比 ,CPAP后 1小时及 4小时的呼吸频率由 5 1± 10次 /分分别减慢至 45± 9次 /分及 39± 12次 /分 (P<0 .0 1) ;动脉血氧分压由 71± 14mm Hg(1mm Hg=0 .133k Pa)分别上升至 10 8± 34mm Hg及 110± 35 mm Hg(P均<0 .0 1) ;二氧化碳分压由 5 0± 7mm Hg分别下降至 45± 6 mm Hg及 43± 13mm Hg,循环状况趋于稳定。 结论 :合理应用鼻塞 CPAP可迅速改善心脏术后急性呼吸衰竭患儿的通气及换气功能 ,减少呼吸功 ,可作为再次气管插管前的补救措施之一。
Objective: To evaluate the therapeutic effect of nasal obstruction positive airway pressure (CPAP) on acute respiratory failure after pediatric cardiac surgery. Methods: Eighteen patients with acute respiratory failure after cardiac surgery were aged 9 months to 6 years old. The changes of blood pressure, heart rate, respiratory rate and arterial blood gas were observed before and after CPAP. Results: The respiratory rate at 1 hour and 4 hours after CPAP was reduced from 51 ± 10 beats to 45 ± 9 beats / minute and 39 ± 12 beats / minute (P <0. 0), respectively 1); arterial partial pressure of oxygen increased from 71 ± 14 mm Hg (1 mm Hg = 0.133 k Pa) to 108 ± 34 mm Hg and 110 ± 35 mm Hg, respectively (P <0.01); the partial pressure of carbon dioxide was 50 ± 7 mm Hg decreased to 45 ± 6 mm Hg and 43 ± 13 mm Hg, respectively, and the circulatory status tended to be stable. Conclusion: Appropriate nasal CPAP treatment can promptly improve ventilation and ventilation in children with acute respiratory failure after cardiac surgery and reduce the work of breathing, which can be used as one of the remedies before re-tracheal intubation.