摘要目的 研究经鼻持续气道正压(NCPAP)改善婴儿左向右分流先心病并心衰患儿心肺功能的效果,评价该治疗方法的优点和安全性.方法 左向右分流先心病并心衰患儿40例,20例随机分配到NCPAP组,予NCPAP治疗.其余20例作为对照组,给予面罩供氧治疗,综合治疗两组相同.在开始治疗时和治疗后1、12、24 h记录呼吸频率、心率、PaO2、PaCO2、pH值、PaO2/FiO2等.结果 治疗后1 h NCPAP组呼吸频率、心率明显改善(P＜0.05);PaO2和PaO2/FiO2均较对照组明显上升(P＜0.05),PaCO2较对照组下降(P＜0.05),且此趋势随时间推移持续.NCPAP组气管插管率显著低于对照组(P＜0.05).结论 NCPAP可改善左向右分流先心病并心衰患儿心肺功能和临床症状、体征,降低患儿气管插管的风险.

abstractsObjective To investigate the effectiveness of nasal continuous positive airway pressure (NCPAP) in improving cardiorespiratory function in left-to-right shunt congenital heart disease infants with heart failure. Assess method quality and safety. Methods Forty left-to-right shunt congenital heart disease infants with heart failure were divided into 2 groups, a group that included 20 patients who decided to receive NCPAP and a control group of 20 patients that received face mask ventilation. Both groups were given conventional medications. Vital signs,PaO2, PaCO2,pH,and PaO2/FiO2 were recorded at the start and 1,12, and 24 hrs into the study. Results Heart rate and respiratory rate with NCPAP improved significantly(P ＜ 0.05). PaO2 and PaO2/FiO2 improved significantly compared with control group after 1 hrs. (P ＜ 0.05, respectively). The trend continued over time. The endotracheal intubation was significantly lower in the NCPAP group than in the control group (P ＜ 0.05). Conclusion Treatment with NCPAP improves cardiorespiratory function and the signs and symptoms of left-to-right shunt congenital heart disease infants with heart failure. NCPAP seems to afford these patients protection from endotracheal intubation.