西宁地区经鼻持续正压通气治疗早产儿肺透明膜病疗效观察

目的探讨高原地区经鼻持续正压通气(NCPAP)治疗早产儿肺透明膜病(HMD)的临床疗效。方法我院2009年1月—2011年1月收住HMD患儿76例,观察NCPAP应用前后呼吸、心率、血压、胸片积分、血气分析相关指标的变化。结果 76例患儿应用NCPAP后气促、紫绀、心动过速等症状缓解。5例NCPAP治疗后缓解不明显,予以气管插管正压通气治疗,3例放弃治疗后死亡,2例存活。71例患儿NCPAP治疗后呼吸及心率明显下降,平均动脉压明显升高,胸片积分明显下降,pH、氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)、动脉血氧饱和度(SaO2)明显升高,差异均有统计学意义(P<0.05)。结论 NCPAP在高原地区治疗HMD简便、安全、有效,可避免有创通气,且不加重高碳酸血症。

Effect of Nasal Continuous Positive Airway Pressure on Hyaline Membrane Disease in Premature Infants in Xining

Objective To evaluate the clinical effect of nasal continuous positive airway pressure(NCPAP) in premature infants with hyaline membrane disease(HMD) in plateau areas.Methods Breathing,heart rate(HR),blood pressure(BP),chest X-ray integral,changes of blood-gas-analysis-related indexes were observed before and after NCPAP treatment,in 76 HMD infants admitted to Qinghai Maternal and Child′s Hospital from January 2009 to January 2011.Results After NCPAP treatment,shortness of breath,cyanosis,tachycardia and other symptoms improved remarkably in 76 infants,not obviously in 5(3 died,2 survived after tracheal intubation positive airway pressure).Breathing and HR decreased remarkably,mean arterial pressure increased,chest X-ray integral reduced,pH,pappenheimer O2(PaO2),pappenheimer CO2(PaCO2),oxygenation index(PaO2/FiO2) and arterial oxygen saturation(SaO2) elevated obviously in 71 cases,the difference was significant(P<0.05).Conclusion NCPAP,an effective and safe method for HMD infants in plateau areas,can avoid application of IPPV which may aggravate hypercapnia.