中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
30期
41-43
,共3页
呼吸窘迫综合征,新生儿%连续气道正压通气%呼吸,人工
呼吸窘迫綜閤徵,新生兒%連續氣道正壓通氣%呼吸,人工
호흡군박종합정,신생인%련속기도정압통기%호흡,인공
Respiratory distress syndrome,newborn%Continuous positive airway pressure%Respiration,artificial
目的 探讨经鼻持续气道内正压(NCPAP)在新生儿呼吸窘迫综合征(NRDS)机械通气撤离后应用的有效性及临床价值.方法 将接受机械通气的92例NRDS患儿按机械抽样法随机分为NCPAP组(46例)和头罩给氧组(46例),比较两组的撤机成功率以及各种并发症如呼吸暂停、支气管肺发育不良、呼吸机相关性肺炎、脑室内出血、脑室周围白质软化、早产儿视网膜病的发生率.结果 NCPAP组41例一次撤机成功,成功率89.13％(41/46),头罩给氧组33例一次撤机成功,成功率71.74％(33/46),两组比较差异有统计学意义(P＜0.05).NCPAP组呼吸暂停、支气管肺发育不良的发生率均低于头罩给氧组[15.22％(7/46)比36.96％ (17/46)、6.52％(3/46)比21.74％(10/46)],两组比较差异有统计学意义(P＜0.05)；两组呼吸机相关性肺炎、脑室内出血、脑室周围白质软化、早产儿视网膜病的发生率比较差异无统计学意义(P＞0.05).结论 NRDS患儿撤机过程中用NCPAP进行过渡比头罩给氧直接脱机更有效,值得在临床实践中进一步研究和推广应用.
目的 探討經鼻持續氣道內正壓(NCPAP)在新生兒呼吸窘迫綜閤徵(NRDS)機械通氣撤離後應用的有效性及臨床價值.方法 將接受機械通氣的92例NRDS患兒按機械抽樣法隨機分為NCPAP組(46例)和頭罩給氧組(46例),比較兩組的撤機成功率以及各種併髮癥如呼吸暫停、支氣管肺髮育不良、呼吸機相關性肺炎、腦室內齣血、腦室週圍白質軟化、早產兒視網膜病的髮生率.結果 NCPAP組41例一次撤機成功,成功率89.13％(41/46),頭罩給氧組33例一次撤機成功,成功率71.74％(33/46),兩組比較差異有統計學意義(P＜0.05).NCPAP組呼吸暫停、支氣管肺髮育不良的髮生率均低于頭罩給氧組[15.22％(7/46)比36.96％ (17/46)、6.52％(3/46)比21.74％(10/46)],兩組比較差異有統計學意義(P＜0.05)；兩組呼吸機相關性肺炎、腦室內齣血、腦室週圍白質軟化、早產兒視網膜病的髮生率比較差異無統計學意義(P＞0.05).結論 NRDS患兒撤機過程中用NCPAP進行過渡比頭罩給氧直接脫機更有效,值得在臨床實踐中進一步研究和推廣應用.
목적 탐토경비지속기도내정압(NCPAP)재신생인호흡군박종합정(NRDS)궤계통기철리후응용적유효성급림상개치.방법 장접수궤계통기적92례NRDS환인안궤계추양법수궤분위NCPAP조(46례)화두조급양조(46례),비교량조적철궤성공솔이급각충병발증여호흡잠정、지기관폐발육불량、호흡궤상관성폐염、뇌실내출혈、뇌실주위백질연화、조산인시망막병적발생솔.결과 NCPAP조41례일차철궤성공,성공솔89.13％(41/46),두조급양조33례일차철궤성공,성공솔71.74％(33/46),량조비교차이유통계학의의(P＜0.05).NCPAP조호흡잠정、지기관폐발육불량적발생솔균저우두조급양조[15.22％(7/46)비36.96％ (17/46)、6.52％(3/46)비21.74％(10/46)],량조비교차이유통계학의의(P＜0.05)；량조호흡궤상관성폐염、뇌실내출혈、뇌실주위백질연화、조산인시망막병적발생솔비교차이무통계학의의(P＞0.05).결론 NRDS환인철궤과정중용NCPAP진행과도비두조급양직접탈궤경유효,치득재림상실천중진일보연구화추엄응용.
Objective To investigate the validity and clinical value of application of nasal continuous positive airway pressure (NCPAP) in neonatal respiratory distress syndrome (NRDS) after weaning from mechanical ventilation.Methods The 92 infants with NRDS received mechanical ventilation were randomly divided into the group of NCPAP (46 cases) and the group of oxygen via head box (46 cases) by systematic sampling method.The successful rate of weaning from mechanical ventilation,and incidence of complications such as apnea,broncho-pulmonary dysplasia,ventilator-associated pneumonia,intraventricular hemorrhage,periventricular leukomalacia,retinopathy of premature infant were compared between the 2 groups.Results The group of NCPAP,41 cases were successful of weaning from mechanical ventilation,the successful rate was 89.13％ (41/46).The group of oxygen via head box,33 cases were successful of weaning from mechanical ventilation,the successful rate was 71.74％(33/46).There was statistical difference between the 2 groups (P ＜0.05).The incidences of apnea and broncho-pulmonary dysplasia in the group of NCPAP were significantly lower than those in the group of oxygen via head box [15.22％ (7/46) vs.36.96％ (17/46),6.52％ (3/46) vs.21.74％ (10/46)],there were statistical differences between the 2 groups (P ＜ 0.05).There were no statistical differences in the incidences of ventilator-associated pneumonia,intraventricular hemorrhage,periventricular leukomalacia,retinopathy of premature infants between the 2 groups (P ＞ 0.05).Conclusion NCPAP is more effective than directly removing respirator in the infants with NRDS weaning from mechanical ventilation,it deserves further study and application in clinical practice.
