无创持续气道正压通气治疗新生儿呼吸衰竭的临床研究

目的：探讨采用无创持续气道正压通气（CPAP）治疗新生儿呼吸衰竭的临床疗效。方法选择2011年1月至2013年9月我院收治的呼吸衰竭新生儿168例，按照随机数字表法分为观察组和对照组各84例。观察组采用新生儿无创呼吸机进行经鼻CPAP治疗，对照组采用头罩法吸氧。观察两组治疗前和治疗1 h后的动脉血气分析变化，评价临床疗效，统计转有创机械通气率。结果观察组和对照组临床总有效率分别为84.5%和67.9%，观察组明显高于对照组，差异具有统计学意义（P＜0.05）；观察组和对照组转有创机械通气率分别为15.5%和32.1%，观察组明显低于对照组，差异具有统计学意义（P＜0.05）；治疗前两组PaO2、SaO2、PaCO2水平比较差异均无统计学意义（P＞0.05）；治疗后，两组PaO2、Sa O2均较治疗前明显升高，PaCO2较治疗前明显降低，观察组改善程度明显优于对照组，差异具有统计学意义（P＜0.05）；两组pH值治疗前后比较差异无统计学意义（P＞0.05）。结论采用无创CPAP治疗新生儿呼吸衰竭临床疗效显著，可迅速改善缺氧状态，降低有创机械通气率，值得临床推广应用。

Clinical research of the neonatal respiratory failure treated by the noninvasive continuous positive airway pressure

Objective To explore the clinical curative effect of the neonatal respiratory failure treated by the noninvasive continuous positive airway pressure （CPAP）. Methods 168 cases with neonatal respiratory failure from January 2011 to September 2013 were divided into observation group and control group according to the random num-ber table method with 84 cases in each one. The observation group was given the nasal CPAP therapy with the neona-tal noninvasive ventilator, and the control group was given hood oxygen. The changes of arterial blood gas analysis of both groups before treatment and 1 hour after treatment were observed. Meanwhile, the clinical curative effect was evaluated, and the invasive mechanical ventilation rates of both groups were statistically analyzed. Results The total＆amp;nbsp;effective rate of the observation group was statistically significant higher than that of the control group （84.5% vs. 67.9%,χ2=4.373, P〈0.05）. And the invasive mechanical ventilation rate of the observation group was statistically sig-nificant lower than that of the control group （15.5%vs. 32.1%,χ2=4.428, P〈0.05）. Before treatment, there was no sta-tistical difference in the PaO2, SaO2, PaCO2 levels between two groups （P〉0.05）. Compared with before treatment, the PaO2 and SaO2 levels of the two groups after treatment were obviously increased, while the PaCO2 level were signifi-cantly decreased. Furthermore, the improvement in observation group was greater than that in control group with sta-tistically significant difference （P〈0.05）. There was no difference in PH value of both groups before and after treat-ment （P〉0.05）. Conclusion The clinical curative effect of the neonatal respiratory failure treated by the CPAP is dis-tinct, which can rapidly improve the anoxic condition and reduce the rate of invasive mechanical ventilation. There-fore, it＆#39;s worthy of clinical promotion and application.