两种不同固定方法在新生儿经鼻持续正压通气的临床应用比较
|
摘要
目的探讨两种不同固定方法对新生儿经鼻持续正压通气(NCPAP)的临床应用效果。方法选择2017年8月至2018年3月西北妇女儿童医院新生儿重症监护病房(NICU)使用NCPAP的患儿136例为研究对象,按随机数字表法分为对照组和观察组,每组各68例。观察组采用自制小帽联合3M弹性棉柔绷带固定鼻塞,并"S"形摆放管道,对照组采用呼吸机厂家配套小帽固定鼻塞;比较两组使用NCPAP期间鼻部皮肤损伤、鼻部变形及每24小时鼻塞脱落次数。结果观察组患儿每24小时鼻塞脱落次数显著低于对照组(t=3.087,P<0.05)。观察组鼻部皮肤轻度损伤发生率为7.35%,显著低于对照组的19.12%(χ~2=4.098,P<0.05),观察组鼻部变形发生率为2.94%,显著低于对照组的14.71%(χ~2=5.849,P<0.05)。结论在新生儿使用NCPAP时,采用一次性尿裤自制小帽联合3M弹力绷带固定,能够明显减少鼻塞脱落次数,降低鼻部皮肤损伤及鼻部变形的发生率,值得临床推广使用。
Objective To investigate the effect of two different fixation methods on the clinical application of nasal continuous positive airway pressure( NCPAP) in neonates. Methods A total of 136 NCPAP patients in the neonatal intensive care unit(NICU) of Northwest Women and Children's Hospital from August 2017 to March 2018 were selected as study subjects, and were divided into control group and observation group according to the random number table method with 68 cases in each group. In the observation group, the nasal obstruction was fixed with self-made small cap combined with 3 M elastic cotton soft bandage, and "S" shaped tubes were placed. In the control group, the nasal obstruction was fixed with matching small cap made by ventilator manufacturers. Nasal skin injury, nasal deformity, and nasal obstruction loss per 24 hours were compared between two groups during the use of NCPAP. Results The number of nasal obstruction loss in the observation group was significantly lower than that in the control group(t=3.087, P<0.05). The incidence of mild nasal skin injury in the observation group was 7.35%, which was significantly lower than that in the control group(19.12%)(χ~2=4.098, P<0.05), and the incidence of nasal deformity was 2.94% in the observation group, which was significantly lower than that in the control group(14.71%)(χ~2=5.849,P<0.05). Conclusion When NCPAP is used in newborns, self-made small cap made with disposable diaper combining 3 M elastic bandage can significantly reduce the number of nasal obstruction drops and the incidence of nose skin injury as well as nose deformation, which is worthy of clinical application.
Objective To investigate the effect of two different fixation methods on the clinical application of nasal continuous positive airway pressure( NCPAP) in neonates. Methods A total of 136 NCPAP patients in the neonatal intensive care unit(NICU) of Northwest Women and Children's Hospital from August 2017 to March 2018 were selected as study subjects, and were divided into control group and observation group according to the random number table method with 68 cases in each group. In the observation group, the nasal obstruction was fixed with self-made small cap combined with 3 M elastic cotton soft bandage, and "S" shaped tubes were placed. In the control group, the nasal obstruction was fixed with matching small cap made by ventilator manufacturers. Nasal skin injury, nasal deformity, and nasal obstruction loss per 24 hours were compared between two groups during the use of NCPAP. Results The number of nasal obstruction loss in the observation group was significantly lower than that in the control group(t=3.087, P<0.05). The incidence of mild nasal skin injury in the observation group was 7.35%, which was significantly lower than that in the control group(19.12%)(χ~2=4.098, P<0.05), and the incidence of nasal deformity was 2.94% in the observation group, which was significantly lower than that in the control group(14.71%)(χ~2=5.849,P<0.05). Conclusion When NCPAP is used in newborns, self-made small cap made with disposable diaper combining 3 M elastic bandage can significantly reduce the number of nasal obstruction drops and the incidence of nose skin injury as well as nose deformation, which is worthy of clinical application.
引文
[1]Pimenta J M,Ebeling M,Montague T H,et al.A retrospective database analysis of neonatal morbidities to evaluate a composite endpoint for use in preterm labor clinical trials [J].AJP Rep,2018,8(1):25-32.
[2]Sakonidou S,Dhaliwal J.The management of neonatal respiratory distress syndrome in preterm infants (European Consensus Guidelines--2013 update)[J].Arch Dis Child Educ Pract Ed,2015,100(5):257-259.
[3]谭葵欢,卢燕玲,黄俐婷.经鼻持续气道正压通气联合不同时机应用肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效观察[J].海南医学,2019,30(1):38-40.
[4]Newnam K M,Mcgrath J M,Estes T,et al.An integrative review of skin breakdown in the preterm infant associated with nasal continuous positive airway pressure[J].J Obstet Gynecol Neonatal Nurs,2013,42(5):508-516.
[5]唐炜,彭娟.新生儿经鼻持续正压通气两种不同固定方法的比较[J].中国实用护理杂志,2016,32(5):355-357.
[6]梁腊梅,曾秋月,陈彩梅,等.水胶体敷料在新生儿经鼻持续气道正压通气中的应用[J].护理实践与研究,2017,14(13):132-133.
[7]Ahmad Z,Venus M,Kisku W,et al.A case series of skin necrosis following use of non invasive ventilation pressure masks[J].Int Wound J,2013,10(1):87-90.
[2]Sakonidou S,Dhaliwal J.The management of neonatal respiratory distress syndrome in preterm infants (European Consensus Guidelines--2013 update)[J].Arch Dis Child Educ Pract Ed,2015,100(5):257-259.
[3]谭葵欢,卢燕玲,黄俐婷.经鼻持续气道正压通气联合不同时机应用肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效观察[J].海南医学,2019,30(1):38-40.
[4]Newnam K M,Mcgrath J M,Estes T,et al.An integrative review of skin breakdown in the preterm infant associated with nasal continuous positive airway pressure[J].J Obstet Gynecol Neonatal Nurs,2013,42(5):508-516.
[5]唐炜,彭娟.新生儿经鼻持续正压通气两种不同固定方法的比较[J].中国实用护理杂志,2016,32(5):355-357.
[6]梁腊梅,曾秋月,陈彩梅,等.水胶体敷料在新生儿经鼻持续气道正压通气中的应用[J].护理实践与研究,2017,14(13):132-133.
[7]Ahmad Z,Venus M,Kisku W,et al.A case series of skin necrosis following use of non invasive ventilation pressure masks[J].Int Wound J,2013,10(1):87-90.