水胶体辅料在早产儿NCPAP中的应用观察

夏时慧

摘要：目的 探讨水胶体敷料在早产儿无创呼吸机辅助通气中对鼻孔周围皮肤的保护作用。方法 选取2016年3月～2017年3月在本院行无创辅助通气治疗的210例早产儿作为研究对象，按照随机数字法将其分为观察组和对照组，每组各105例。对照组采用常规方法护理，观察组早产儿在此基础上加用水胶体敷料，比较两组患儿的鼻部皮肤破损情况，呼吸机鼻塞歪曲脱落情况。结果 观察组皮肤破损发生率（4.76%）明显低于对照组（26.66%）；呼吸机鼻塞歪曲脱落情况观察组（6.66%）明显低于对照组（18.09%）。结论 水胶体敷料在早产儿无创机械通气中应用效果显著，能够有效地减少患儿的皮肤破损情况，减少呼吸机鼻塞歪曲脱落率，值得在临床研究与新生儿护理中加以推广和运用。

关键词：水胶体敷料；早产儿；无创辅助通气

中图分类号：R473.72 文献标识码：A 文章编号：1006-1959（2017）20-0153-02

Abstract：Objective To investigate the protective effect of hydrocolloid dressings without the skin around the nose invasive ventilation in preterm infants.Methods 210 cases of premature infants in March 2016～March 2017，the non-invasive assisted ventilation treatment in our hospital as the research object，randomly divided into observation group and control group，105 cases in each group.The control group received conventional nursing， the observation group was treated with hydrocolloid dressing on the basis of the premature infants.The nasal skin lesions of the two groups were compared，and the nasal congestion，distortion and shedding of the ventilator were compared.Results The observation group 4.76% incidence of skin damage was significantly lower than the control group 26.66%；ventilator nasal distorted shedding 6.66% of the observation group was significantly lower than the control group 18.09%.Conclusion Hydrocolloid dressing in premature application effect of noninvasive mechanical ventilation significantly，can effectively reduce the patients with skin damage，reduce ventilator nasal shedding rate distortion，it is worth to be promoted and used in clinical research and nursing of neonatal care.

Key words：Hydrocolloid dressing；Preterm infants；Noninvasive assisted ventilation

呼吸支持是危重早产儿管理中最为重要的环节之一。新生儿呼吸衰竭作为新生儿重症监护病房中最常见的危重症，易导致较高的病死率[1]。鼻塞式CPAP是对有自主呼吸新生儿经鼻塞于呼吸回路中在呼气终末时提供正压，使新生儿肺泡在异常情况下保持扩张不至于萎缩，从而改善通气，提高早产儿的生命健康水平。在使用鼻塞法对早产儿进行辅助通气时遇到的问题是鼻孔小，鼻塞不容易固定[2]。如果固定太紧，便会对早产儿的鼻黏膜以及周围皮肤造成严重损伤，鼻部损伤是临床中常见的 NCPAP引起的并发症，发生率为 20%～60%[3]。……