俯卧位鼻塞持续气道正压通气在早产儿呼吸暂停中的应用效果

目的：研究俯卧位鼻塞持续气道正压通气对早产儿呼吸暂停的影响。方法选择NICU收治的鼻塞持续气道正压通气的早产儿80例，按随机数字表法分为俯卧组和仰卧组各40例，两组均予经鼻持续气道正压通气（ NCPAP）和氨茶碱治疗以及相关护理，比较两组治疗效果。结果俯卧组在治疗早产儿呼吸暂停中总有效率为97．5％，仰卧组82．5％，两组比较差异有统计学意义（χ2＝8．41 ；P＜0．01）±俯卧组的PaO2和PaO2/FiO2分别为（77．24±9．56），（171．25±31.13）mmHg，均高于仰卧组的（67．52±8．61），（143．26±26．34）mmHg，差异有统计学意义（t分别为2．16，2．14；P＜0．05）±俯卧组的上机时间、住院时间、氨茶碱使用时间分别为（3．65±2．01），（28．25±3．98），（10．82±9．08）d；均低于仰卧组的（4．83±3．51），（30．14±12．61），（12．2±9．37）d，差异有统计学意义（t分别为0．23，1．96，2．37；P＜0．05）。结论鼻塞持续气道正压通气早产儿采取俯卧位时，可改善氧合、提高PaO2和氧合指数，并可减少呼吸暂停的发生，缩短上机和使用氨茶碱时间，减少气管插管机械通气的需要，减少住院时间，减少住院费用，减轻家长的经济负担。

Effect of nasal continuous positive airway pressure in prone position on the premature infants with apnea

Objective The aim of this study is to assess the effect of nasal continuous positive airway pressure （ NCPAP） in prone position on the treatment of the premature infants with apnea .Methods Totals of 80 premature infants treated with NCPAP in the NICU from January to December , 20±2 were observed . According to the random number table method , the premature infants were divided into prone position group and supine position group . Each group was treated with NCPAP and aminophylline , and relevant nursing intervention.The changes of their frequencies of apnea , PEEP, FiO2 , PaO2 , and PaCO2 , etc.were observed and compared.Results The effective rate of the prone group was 9±.5% and the effective rate of the supine group was 82.5%.The difference was significant （χ2 =8.4±, P±lt±0.05）.The PaO2 and PaO2/FiO2 in the prone group were （77.24±9.56）,（171.25±31.13）mmHg, respectively, which were higher than （67.52±8.61）,（143.26±26.34）mmHg in the supine group.The differences were significant （t =2.16, 2.14, respectively;P〈0.05）.The time of ventilation, hospital stays and use of aminophylline were （3.65±2.01）,（28.25±3.98）,（10.82±9.08）d, which were lower than （4.83±3.51）,（30.14±12.61）,（12.2±9.37）d in the supine group, the differences were significant （t=0.23, 1.96, 2.37, respectively;P〈0.05）. Conclusions Compared with the traditional supine position , treating the neonate with NCPAP in prone position can not only improve their oxygenation , PaO2 and oxygenation indexes , but also reduce the risk of apnea , as well as shortening the time of ventilation and using of aminophylline .It also reduces the treatment of intubation and ventilation, and relieves the financial burden of hospitalization on the infant ’ parents.