鼻塞式連續氣道正壓通氣（NCPAP）早產兒鼻部損傷的預防策略

摘要：目的 探討對鼻塞式連續氣道正壓通氣早產兒鼻部損傷采取的有效護理干預方法及護理效果。方法 對40例采用NCPAP進行呼吸支持的早產兒進行觀察，對照組20例早產兒采取常規護理，護理組20例早產兒采用鼻部損傷的預防護理措施，觀察兩組早產兒的PaO2、PaCO2、滿意度、鼻部損傷發生率。結果 護理組鼻部損傷發生率、PaCO2明顯低于對照組，護理組的PaO2、護理滿意度明顯優于對照組，有統計學意義（P<0.05）。結論 對采用NCPAP進行呼吸支持的早產兒采取預防鼻部損傷的護理措施可以降低鼻部損傷發生率，提高早產兒家屬對護理的滿意度，改善早產兒的血氧水平。

關鍵詞：NCPAP；早產兒；鼻部損傷；預防策略

Prevention Strategies for Nose Injury in Premature Infants under NCPAP

WEI Tao

（Newborns Intensive Care Unit of Chongzhou Hospital， Chongzhou 611230，Sichuan，China）

Abstract：Objective To explore the effective nursing interventions and nursing effects of nasal injuries in premature infants under nasal continuous positive airway pressure （NCPAP）. Methods 40 premature infants given NCPAP for respiratory support were observed， which were divided into a control group and an observation group： the 20 infants in the control group were given routine care and the 20 in the nursing group given preventive nursing measures for nasal injuries. The PaO2， PaCO2， satisfaction and incidence of nose injuries in the two groups were compared. Results The incidence of nose injuries and PaCO2 in the nursing group were shown to be significantly lower than the control group， and the PaO2 and nursing satisfaction in the nursing group were shown to be better than the control group， with the differences being statistically significant （P<0.05）. Conclusion For premature infants under NCPAP respiratory support， preventitive measures can reduce the incidence of nose injury， and improve the satisfaction of their family members and the blood oxygen levels in premature infants.

Key words：NCPAP； Premature infants； Nasal injury； Prevention strategies

早產兒因沒有足月生產，器官發育不完整，容易出現呼吸窘迫綜合征，常需要氧療進行呼吸支持，滿足新生兒的呼吸需要。NCPAP是近年來廣泛應用于早產兒呼吸支持的一種無創呼吸模式，充分滿足早產兒的呼吸需要，適用于極低體重早產兒，可以保證氧氣吸入質量，減少漏氧[1]。但是隨著NCPAP的推廣，其并發癥也日益凸顯，影響通氣的正常進行，如鼻部損傷、氣胸、壓瘡等。鼻部損傷是NCPAP最常見的一種并發癥，長期通氣會壓迫鼻部組織，新生兒皮膚嬌嫩、好動都會引起鼻部血液循環障礙，鼻塞滑落等因素都會導致鼻部損傷，不利于通氣的正常進行，給早產兒造成了巨大的痛苦。所以針對NCPAP容易引起鼻部損傷這一現狀采取早期預防護理干預，可以降低鼻部損傷發生率。

1資料與方法……