湿化高流量鼻导管通气在新生儿呼吸窘迫综合征撤机后的应用研究  

Clinical application of humidified high-flow nasal catheter ventilation in neonatal respiratory distresssyndrome after weaning

作　　者：陈历耋[1] 王淑莲[1] 廖奇[1] 

机构地区：[1]娄底市中心医院新生儿科,417000

出　　处：《国际医药卫生导报》2018年第1期37-40,共4页International Medicine and Health Guidance News

摘　　要：目的比较湿化高流量鼻导管通气（HHFNC）与经鼻持续气道正压通气（nCPAP）在新生儿呼吸窘迫综合征（NRDS）撤机后的临床应用研究。方法回顾性分析2014年2月至2017年2月本院新生儿呼吸窘迫综合征行有创呼吸机治疗患儿120例，按撤离呼吸机后使用不同呼吸支持方式分为HHFNC组与nCPAP两组。比较两组患儿的鼻部损伤率、重新气管插管率、气漏及支气管肺发育不良发生率，应用NCPAP／HHFNC后1h的PaO2和PCO2值、撤机时间、住院时间、机械通气时间、呼吸机治疗费、坏死性小肠结肠炎、严重脑室内出血、早产儿视网膜病发生率、病死率等。结果和NCPAP组相比，HHFNC组鼻损伤较少，呼吸机治疗费用也较低，差异有统计学意义（P〈0．05）。两组患儿的重新气管插管率、气漏及支气管肺发育不良（BPD）发生率、应用NCPAP／HHFNC后1h的PaO2和PCO2值、撤机时间、住院时间、机械通气时间、坏死性小肠结肠炎（NEC）、严重脑室内出血（IVH）、早产儿视网膜病（ROP）发生率、病死率等比较差异均无统计学意义（均P〉0．05）。结论HHFNC是一种临床上使用方便、操作简单的呼吸支持方式，较nCPAP能显著提高患儿舒适度，患儿更容易耐受，同时鼻部损伤及呼吸机治疗费用更少，是值得推广的呼吸支持方式。Objective To compare the clinical application of humidified high-flow nasal catheter ventilation （HHFNC） and nasal continuous positive airway pressure （nCPAP） in neonatal respiratory distress syndrome after weaning. Methods 120 cases of neonatal respiratory distress syndrome treated with invasive ventilator in our hospital from February 2014 to February 2017 were divided into HHFNC group and nCPAP group according to different respiratory support methods after weaning. The incidences of nasal injury, recurrent intubation, air leakage, and bronchopulmonary dysplasia were compared between the two groups. PaO2 and PCO2 levels were measured 1 h after the application of nCPAP/HHFNC, the weaning time, hospitalization time, mechanical ventilation time, ventilator treatment costs, the incidences of necrotizing enterocolitis, severe intraventricular hemorrhage, retinopathy in premature children, the mortality and so on were compared between the two groups. Results Compared with nCPAP group, HHFNC group had lower incidence of nasal injury and less cost of ventilator treatment, with statistically significant differences （P〈0.05）. There were no statistically significant differences in the incidences of recurrent intubation, air leakage, and bronchopulmonary dysplasia, PaO2 and PCO2 levels 1 h after the application of nCPAP/HHFNC, the weaning time, hospitalization time, mechanical ventilation time, the incidences of necrotizing enterocolitis, severe intraventricular hemorrhage, retinopathy in premature children, the mortality between the two groups （p〉0.05）. Conclusion HHFNC is a kind of clinical respiratory support method, easy to use, simple to operate, which can significantly improve the comfort degree of the children compared with nCPAP, more easily tolerated by children, with less nose damage and less ventilator treatment costs, worthy of promotion.

关 键 词：呼吸窘迫综合征 新生儿 湿化高流量鼻导管通气 

分 类 号：R722.6[医药卫生—儿科]