经湿化高流量鼻导管通气治疗新生儿肺透明膜病66例的临床效果分析  

Clinical effect analysis on 66 cases of neonatal hyaline membrane disease treated by heated humidified high-flow nasal cannula

作　　者：王越[1] 高薇薇[1] 杨杰[1] 聂川[1] 黄晓睿[1] 徐龙昌[2] 

机构地区：[1]广东省妇幼保健院新生儿科,广州511442 [2]广东省妇幼保健院保健部,广州511442

出　　处：《国际医药卫生导报》2013年第14期2081-2083,共3页International Medicine and Health Guidance News

基　　金：广东省医学科学技术研究基金资助项目（A2011076）

摘　　要：目的 探讨经湿化高流量鼻导管通气（HHFNC）在新生儿肺透明膜病中的临床应用效果.方法 66例诊断为Ⅰ～Ⅱ级新生儿肺透明膜病的早产儿采用经湿化高流量鼻导管通气（HHFNC）治疗,观察治疗前后临床症状和血气指标.初始参数设置：Flow 2～8 L/min,FiO2 0.21～0.40.观察记录患儿治疗后72 h的临床情况：若患儿血气分析PaCO2＞65 mmHg,FiO2＞0.5;出现严重呼吸暂停（1h内出现3次伴有心率减慢的呼吸暂停,或出现1次呼吸暂停需要正压通气）考虑为使用该辅助呼吸支持模式治疗失败,需气管插管机械辅助通气.结果 66例患儿中,59例经治疗后顺利撤除HHFNC,另外7例需转为气管插管机械辅助通气.结论 经湿化高流量鼻导管通气（HHFNC）能对轻度新生儿肺透明膜病进行呼吸支持,改善其低氧血症.Objective To explore the clinical effects of heated humidified high-flow nasal cannula （HHFNC） in treating neonatal hyaline membrane disease （NHMD）.Methods 66 infants were diagnosed as mild NHMD according clinical findings and chest X-ray.HHFNC was used after building diagnosis.We adjusted HHFNC parameter according patients＇ arterial blood gas.Results 59 of 66 patients were fully recovered using HHFNC treatment.7 patients were incubated and used mechanical ventilation.Conclusion HHFNC is an available and effective treatment method for mild NHMD and provide respiratory support,and can improve hyoxemia symptoms.

关 键 词：经湿化高流量鼻塞氧疗 新生儿肺透明膜病 无创性呼吸支持模式 

分 类 号：R722.1[医药卫生—儿科]