经鼻高流量鼻导管湿化氧疗治疗新生儿肺炎并呼吸衰竭PaCO_2、pH值及PaO_2水平的疗效评价
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摘要
目的探讨经鼻高流量鼻导管湿化氧疗治疗新生儿肺炎并呼吸衰竭PaCO_2、pH值及PaO_2水平的疗效。方法方便选取定2018年1—12月到该院接受治疗的128例新生儿肺炎并呼吸衰竭患者,随机分为对照组64例(常规吸氧)与观察组64例(经鼻高流量鼻导管湿化氧疗),比较两组各项临床指标。结果治疗结束,观察组PaO_2、pH值指标均高于对照组,差异有统计学意义(P<0.05),观察组PaO_2指标为(88.74±9.67)mmHg,pH值指标为(7.47±0.32)(t=8.343,28.008;观察组PaCO_2、住院时长、气促改善时长、发绀改善时长、肺部啰音消失时长指标均低于对照组且差异有统计学意义(P<0.05),PaCO_2指标为(34.25±7.14)mmHg(t=5.729,P<0.05);观察组总有效率(98.44%)指标高于对照组(81.25%),差异有统计学意义(χ~2=10.360,P<0.05)。结论经鼻高流量鼻导管湿化氧疗方法可有效改善新生儿肺炎并呼吸衰竭患者预后,值得推广使用。
Objective To investigate the efficacy of nasal high-flow nasal catheter humidification oxygen therapy in the treatment of neonatal pneumonia and respiratory failure with PaCO_2, p H and PaO_2 levels. Methods A total of 128 patients with neonatal pneumonia and respiratory failure who were treated in our hospital from January to December 2018 were convenient selected and randomly divided into the control group(64 cases, with conventional oxygen) and the observation group(64 cases, with nasal catheter humidification oxygen therapy). Compared the clinical indicators of the two groups. Results At the end of treatment, the PaO_2 and pH values of the observation group were higher than the control group, and the difference was statistically significant(P<0.05). The PaO_2 index of the observation group was(88.74±9.67)mmHg, pH index was(7.47±0.32)(t=8.343, 28.008), respectively. In the observation group, PaCO_2, hospitalization duration, duration of shortness of breath improvement, length of improvement of hair loss, and duration of disappearance of lung voice were lower than those in the control group, and the difference was statistically significant(P<0.05). The PaCO_2 index was(34.25±7.14)mmHg,(t=5.729, P<0.05), respectively. The total effective rate of the observation group(98.44%) was higher than that of the control group(81.25%), and the difference was statistically significant(χ~2=10.360,P<0.05). Conclusion Nasal high-flow nasal catheter humidification oxygen therapy can effectively improve the prognosis of neonates with pneumonia and respiratory failure, which is worthy of popularization.
Objective To investigate the efficacy of nasal high-flow nasal catheter humidification oxygen therapy in the treatment of neonatal pneumonia and respiratory failure with PaCO_2, p H and PaO_2 levels. Methods A total of 128 patients with neonatal pneumonia and respiratory failure who were treated in our hospital from January to December 2018 were convenient selected and randomly divided into the control group(64 cases, with conventional oxygen) and the observation group(64 cases, with nasal catheter humidification oxygen therapy). Compared the clinical indicators of the two groups. Results At the end of treatment, the PaO_2 and pH values of the observation group were higher than the control group, and the difference was statistically significant(P<0.05). The PaO_2 index of the observation group was(88.74±9.67)mmHg, pH index was(7.47±0.32)(t=8.343, 28.008), respectively. In the observation group, PaCO_2, hospitalization duration, duration of shortness of breath improvement, length of improvement of hair loss, and duration of disappearance of lung voice were lower than those in the control group, and the difference was statistically significant(P<0.05). The PaCO_2 index was(34.25±7.14)mmHg,(t=5.729, P<0.05), respectively. The total effective rate of the observation group(98.44%) was higher than that of the control group(81.25%), and the difference was statistically significant(χ~2=10.360,P<0.05). Conclusion Nasal high-flow nasal catheter humidification oxygen therapy can effectively improve the prognosis of neonates with pneumonia and respiratory failure, which is worthy of popularization.
引文
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[12]林新祝,郑直,李雅丹,等.高频振荡通气、肺表面活性物质联合一氧化氮吸入治疗新生儿低氧性呼吸衰竭的临床研究[J].中国当代儿科杂志,2013,15(12):1068-1073.
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[15]王维建,刘晓菊.氨茶碱联合无创正压通气治疗慢性阻塞性肺气肿合并呼吸衰竭疗效评价[J].中国医药导报,2013,10(6):70-72.
[16]展翼翼,姜芸,谢姆孜牙·买买提热夏提,等.有创机械通气与无创机械通气治疗肺动脉高压并呼吸衰竭临床疗效的比较研究[J].实用心脑肺血管病杂志,2016,24(3):60-62.
[17]王敏智,何柳芳,王敏智,等.小剂量牛肺表面活性物质结合高频震荡通气对新生儿呼吸衰竭临床症状及呼吸状态的改善效果观察[J].安徽医学,2016,37(1):5-8.
[18]许云波,程红斌.经鼻高流量鼻导管湿化氧疗治疗新生儿肺炎合并呼吸衰竭的临床疗效[J].中国妇幼保健,2017,32(13):3077-3080.
[2]冯帼,刘素丽,崔伟伦.加温湿化高流量鼻导管通气治疗新生儿胎粪吸入综合征合并Ⅰ型呼吸衰竭的临床疗效[J].实用心脑肺血管病杂志,2017,25(4):99-101.
[3]李志伟,李超,董权,等.经鼻高流量氧疗与无创通气治疗腹部外科术后患者脱机后低氧血症的临床疗效比较[J].昆明医科大学学报,2017,38(1):65-69.
[4]代光华,李丹丹.高流量鼻导管氧疗联合维生素营养补充剂对新生儿肺炎合并呼吸衰竭的效果观察[J].解放军医药杂志,2016,28(10):61-64.
[5]韩海玲,淡云,卫文峰.精细化护理对于新生儿重症肺炎合并呼吸衰竭的影响研究[J].中国医学装备,2016,13(7):94-97.
[6]何涓.盐酸氨溴索静注联合鼻塞式持续正压通气对新生儿肺炎血气指标的影响[J].中国妇幼保健,2016,31(11):2324-2325.
[7]杨竹.集束化护理方案对经鼻呼吸道正压通气治疗重症肺炎新生儿预后的影响[J].山西医药杂志,2015,44(17):2084-2086.
[8]岳梅枝.呼吸机肺保护性通气与序贯通气治疗老年重症肺炎合并呼吸衰竭的疗效比较[J].医学综述,2014,20(16):3043-3045.
[9]黄梅,韦丹,何炎志,等.高流量鼻导管湿化氧疗在新生儿肺炎并呼吸衰竭中的应用[J].中国新生儿科杂志,2014,29(4):247-250.
[10]戴立英,傅燕娜,张健,等.肺表面活性物质联合高频振荡通气和吸入一氧化氮治疗新生儿重度呼吸衰竭的临床疗效研究[J].中国全科医学,2014,17(19):2235-2238,2242.
[11]刘艳红,赵先锋,贾美云,等.高频振荡通气联合肺表面活性物质治疗呼吸衰竭早产儿疗效观察[J].山东医药,2014,54(8):49-51.
[12]林新祝,郑直,李雅丹,等.高频振荡通气、肺表面活性物质联合一氧化氮吸入治疗新生儿低氧性呼吸衰竭的临床研究[J].中国当代儿科杂志,2013,15(12):1068-1073.
[13]蒋丽,蓝继奎,蒋杰.新生儿肺炎伴肺动脉高压采用真武汤联合西药的治疗分析[J].中华医院感染学杂志,2013,23(14):3438-3440.
[14]魏晓晔,周萍.常频通气联合高频振荡通气治疗新生儿呼吸衰竭68例疗效分析[J].临床和实验医学杂志,2013,12(6):452-453.
[15]王维建,刘晓菊.氨茶碱联合无创正压通气治疗慢性阻塞性肺气肿合并呼吸衰竭疗效评价[J].中国医药导报,2013,10(6):70-72.
[16]展翼翼,姜芸,谢姆孜牙·买买提热夏提,等.有创机械通气与无创机械通气治疗肺动脉高压并呼吸衰竭临床疗效的比较研究[J].实用心脑肺血管病杂志,2016,24(3):60-62.
[17]王敏智,何柳芳,王敏智,等.小剂量牛肺表面活性物质结合高频震荡通气对新生儿呼吸衰竭临床症状及呼吸状态的改善效果观察[J].安徽医学,2016,37(1):5-8.
[18]许云波,程红斌.经鼻高流量鼻导管湿化氧疗治疗新生儿肺炎合并呼吸衰竭的临床疗效[J].中国妇幼保健,2017,32(13):3077-3080.