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目的:探讨鼻塞持续气道正压通气(CPAP)与机械通气对新生儿呼吸窘迫综合征(NRDS)的疗效比较。方法选取2014年3月至2016年3月来台山市妇幼保健院接受治疗的I~II级NRDS患儿86例,采用完全随机设计将其随机分为采用CPAP治疗的CPAP组和采用常规机械通气治疗的通气组,每组43例,观察两组患儿治疗效果以及不同时间段的血气分析结果。结果 CPAP组有效率72.09%显著高于通气组67.44%,差异具有统计学意义(P<0.05);CPAP组二氧化碳分压(PaCO_2)、氧分压(PaO_2)、p H以及氧分压/吸入氧浓度(PaO_2/FiO_2)T1~T5时段的各数据均优于T0时段,通气组各项指标的T2~T5时段各数据与T0时段相比,CPAP组在T2~T5时段PaO_2以及PaCO_2监测数据显著优于通气组,在T1~T5时段,PaO_2/FiO_2的监测数据显著高于通气组,差异具有统计学意义(P<0.05);两组p H各个时段检测数据差异无统计学意义(P>0.05)。CPAP组总不良反应发生率9.30%显著低于通气组27.91%,差异具有统计学意义(P<0.05)。结论 CPAP能够有效地提高NRDS治疗有效率,且有效纠正酸碱平衡紊乱,改善血气异常,但其对于重症患儿治疗效果仍然不理想,需要采用呼吸机辅助治疗,避免出现紧急状况。
Objective: To compare the efficacy of nasal continuous positive airway pressure (CPAP) and mechanical ventilation on neonatal respiratory distress syndrome (NRDS). Methods Totally 86 children with Grade I ~ II NRDS who came to Taichung MCH from March 2014 to March 2016 were randomly divided into CPAP group treated with CPAP and general mechanical ventilation Treatment of ventilation group, 43 cases in each group, to observe the therapeutic effect of two groups of children and blood gas analysis results at different time periods. Results The effective rate of CPAP group was 72.09%, which was significantly higher than that of ventilation group (67.44%) (P <0.05). In CPAP group, PaCO_2, PaO_2, p H and partial pressure of oxygen Data of PaO2 / FiO2 at T1 ~ T5 were better than those at T0. Compared with T0 at T2 ~ T5, the data of PaO2 and PaCO2 in CPAP at T2 ~ T5 (P <0.05). There was no significant difference between the two groups in the detection of p H at each time point (P > 0.05). The incidence of total adverse reactions in CPAP group was significantly lower than that in ventilatory group (9.30% vs 27.91%, P <0.05). Conclusion CPAP can effectively improve the NRDS treatment efficiency, and effectively correct the acid-base balance disorders and improve blood gas abnormalities, but its effect is still not ideal for children with severe illness, need to use ventilator-assisted therapy to avoid emergencies.