湿化高流量鼻导管通气治疗小婴儿肺炎及毛细支气管炎的临床分析  

Humidified high-flow nasal cannula in treatment of babies less than six months old with pneumonia and capillary bronchiolitis

作　　者：刘银霞 张俭 邵秀敏 尹云欢 梁道喜 LIU Yinxia;ZHANG Jian;SHAO Xiumin;YIN Yunhuan;LIANG Daoxi(Qingxi Hospital of Dongguan City,Dongguan 523660,China)

机构地区：[1]东莞市清溪医院儿科,广东东莞523660

出　　处：《中国中西医结合儿科学》2018年第1期9-11,共3页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：广东省东莞市科技计划项目(201610515000970)

摘　　要：目的观察湿化高流量鼻导管通气(HHFNC)在小婴儿肺炎、毛细支气管炎的临床应用效果。方法 2016年3月至2017年3月东莞市清溪医院新生儿科、儿科收治年龄≤6个月诊断为肺炎、毛细支气管炎,出现低氧血症(经皮血氧饱和度<90%或经皮血氧饱和度在90%~94%经鼻导管给氧治疗后无好转)的患儿60例,随机分为HHFNC组和鼻塞式持续气道正压通气(nCPAP)组各30例。观察两组3d内和7d内患儿依从性(患儿自行拔除鼻导管或家属要求拔除鼻导管例数)和腹胀和鼻中隔损伤发生率,使用无创呼吸支持时间及总用氧时间。结果 HHFNC组3d及7d内患儿依从性分别为10.0%(3/30)、16.7%(5/30),显著低于nCPAP组33.3%(10/30)、63.3%(19/30),腹胀发生率、鼻中隔损伤率分别为10.0%(3/30)、3.3%(1/30),显著低于nCPAP组73.3%(22/30)、26.7%(8/30),差异有统计学意义(P<0.05)。两组高碳酸血症发生率比较差异无统计学意义。两组使用无创呼吸支持时间及总用氧时间比较差异无统计学意义。结论 HHFNC能更舒适地对小婴儿肺炎、毛细支气管炎进行呼吸支持,其依从性较好。Objective To observe the clinical effects of humidified high flow nasal cannula(HHFNC)in infants with pneumonia and capillary bronchitis.Methods Totally 60 cases of infants less than six months old diagnosed with pneumonia or capillary bronchitis between March 2016 and March 2017 were randomly divided into two groups on the basis of different respiratory support mode,with 30 cases in HHFNC group and the other 30 cases in nCPAP group,who had hypoxemia(transcutaneous oxygen saturation was under 90%or between 90%and 94%but had no improvement after oxygenation treatment with nasal catheters).The children's compliance(the number of cases with nasal catheters drawn by themselves or asked to be pulled off by family members)within 3 days and 7 days after treatment,abdominal distension and incidence of nasal septum injury,noninvasive respiratory support time and total time of oxygen use were observed.Results The 3d and 7d compliance rate of HHFNC group was 10.0%(3/30)and 16.7%(5/30),which was significantly lower than that of nCPAP group[(33.3%,10/30),(63.3%,19/30)];the incience rate of abdominal distension and nasal septum injury was 10.0%(3/30)and 3.3%(1/30),significantly lower than that in nCPAP group[(73.3%,22/30),(26.7%,8/30)];the difference was of statistical significance(P<0.05).There was no statistical difference in the incidence of hypercapnia,noninvasive respiratory support time or total time of oxygen use between the two groups.ConclusionHHFNC,which provides respiratory support more cozily to infants with pneumonia or capillary bronchitis,has better compliance.

关 键 词：毛细支气管炎 湿化高流量鼻导管通气 鼻塞式持续气道正压通气 婴幼儿 

分 类 号：R725.6[医药卫生—儿科]