无创高频通气治疗极低/超低出生体重儿呼吸窘迫综合征的疗效及安全性研究  

Efficacy and safety of non-invasive high-frequency oscillatory ventilation in very low birth weight/extremely low birth weight infants with respiratory distress syndrome

作　　者：邹芳[1] 唐文燕[1] ZOU Fang;TANG Wenyan(Jiangxi Maternal and Child Health Hospital,Nanchang 330006,China)

机构地区：[1]江西省妇幼保健院,南昌330006

出　　处：《江西医药》2020年第12期1777-1780,共4页Jiangxi Medical Journal

基　　金：江西省卫生计生委科技计划课题,编号20185420。

摘　　要：目的探讨无创高频通气治疗极低/超低出生体重儿呼吸窘迫综合征的疗效及安全性。方法选择2017年6月至2019年6月在我院分娩的胎龄<31周,出生体质量<1500g的极低/超低出生体重儿,入院时诊断呼吸窘迫综合征且使用无创辅助通气的患儿120例,随机分成观察组和对照组各为60例,观察组为无创高频通气(NHFOV)联合肺表面活性物质治疗,对照组为经鼻间歇正压通气(NIPPV)联合肺表面活性物质治疗。比较两组患儿辅助通气治疗前及治疗6h后血气中pH、PCO2及PO2三项指标变化,以及两组患儿病情痊愈或好转出院时统计呼吸暂停、支气管肺发育不良、肺出血、颅内出血、早产儿视网膜病变、腹胀等并发症的发生率(支气管肺发育不良和早产儿视网膜病变均在患儿出生4-6周后诊断)。结果无创高频通气可降低二氧化碳分压,减少呼吸暂停、支气管肺发育不良及早产儿视网膜病变的发生率,并未增加肺出血、颅内出血及腹胀的发生率。结论无创高频通气治疗极低/超低出生体重儿呼吸窘迫综合征安全、有效。Objective To explore the efficacy and safety of non-invasive high-frequency ventilation in the treatment of respiratory distress syndrome in very low birth weight/extremely low birth weight infants.Methods one hundred and twenty very low birth weight/extremely low birth weight infants born in our hospital from June 2017 to June 2019,who were diagnosed with respiratory distress syndrome and received non-invasive assisted ventilation at the time of admission,were randomly divided into experimental group(n=60)and control group(n=60).The experimental group was treated with non-invasive high frequency oscillatory ventilation(NHFOV)combined with pulmonary surfactant,and the control group was treated with nasal intermittent positive pressure ventilation(NIPPV)combined with pulmonary surfactant.The efficacy was compared by pH value,partial pressure of carbon dioxide and oxygen partial pressure of blood gas between the two groups of children before and after 6 hours of treatment.And the two groups of children were compared with apnea,bronchopulmonary dysplasia,pulmonary hemorrhage,intracranial hemorrhage,retinopathy of prematurity and abdominal distension.Results NHFOV can reduce the partial pressure of carbon dioxide,reduce the incidence of apnea,bronchopulmonary dysplasia,and retinopathy of prematurity,without increasing the incidence of pulmonary hemorrhage,intracranial hemorrhage and abdominal distension.Conclusion NHFOV is safe and effective in the treatment of very low birth weight/extremely low birth weight infants with respiratory distress syndrome.

关 键 词：无创高频通气 经鼻间歇正压通气 极低/超低出生体重儿 呼吸窘迫综合症 疗效及安全性 

分 类 号：R722.1[医药卫生—儿科]