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目的比较鼻塞式持续气道正压通气(NCPAP)与常频机械通气(CMV)辅助治疗早产儿呼吸衰竭的效果。方法以回顾性分析的方法,选取2002年1月-2009年12月在苏州大学附属儿童医院新生儿科住院治疗的43例呼吸衰竭早产儿。其中20例应用NCPAP治疗(NCPAP组),23例应用CMV治疗(CMV组)。比较两组患儿治疗24 h后的血气变化、治愈率及停氧时间。结果两组治疗前后血气比较差异均有统计学意义(P<0.01),组间比较差异亦有统计学意义(P<0.01)。NCPAP组治愈率45.0%,CMV组治愈率78.3%,两组比较差异有统计学意义(χ2=5.065,P<0.05)。两组停氧时间比较差异无统计学意义(P=0.1156)。结论针对早产儿呼吸衰竭,CPAP可以有效提高血氧饱和度,缓解呼吸困难,当病情进展,应及时更换为机械通气方式。
Objective To compare the effects of nasal continuous positive airway pressure (NCPAP) and conventional mechanical ventilation (CMV) in the treatment of respiratory failure in preterm infants. Methods From January 2002 to December 2009, 43 preterm infants with respiratory failure who were hospitalized in neonatology department of Children’s Hospital Affiliated to Soochow University from January 2002 to December 2009 were retrospectively analyzed. Among them, 20 cases were treated with NCPAP (NCPAP group) and 23 cases were treated with CMV (CMV group). The changes of blood gas, the cure rate and the time of stopping oxygen in 24 hours after treatment were compared between the two groups. Results There was significant difference in blood gas between the two groups before and after treatment (P <0.01). The differences between the two groups were also statistically significant (P <0.01). The cure rate of NCPAP group was 45.0%, and the cure rate of CMV group was 78.3%. There was significant difference between the two groups (χ2 = 5.065, P <0.05). There was no significant difference between the two groups in the time of stopping oxygen (P = 0.1156). Conclusions CPAP can effectively improve the oxygen saturation and alleviate the respiratory problems of respiratory failure in premature infants. When the disease progresses, CPAP should be promptly replaced by mechanical ventilation.