应用HHHFNC预防新生儿拔管失败的临床研究  

Clinical study of HHHFNC to prevent neonatal extubation failure

作　　者：陶荔[1] 陈丽萍[1] 晏长红[1] TAO Li;CHEN Li-ping;YAN Chang-hong(Department of Neonatology,Jiangxi Provincial Children′s Hospital,Jiangxi Province,Nanchang330000,China)

机构地区：[1]江西省儿童医院新生儿科,江西南昌330000

出　　处：《中国当代医药》2021年第10期54-56,共3页China Modern Medicine

基　　金：江西省卫生计生委科技计划项目(20185461)。

摘　　要：目的探讨加温湿化高流量鼻导管通气(HHHFNC)预防新生儿拔管失败的效果。方法选取江西省儿童医院2016年6月~2019年6月新生儿重症监护病房接收的211例应用气管插管后需无创辅助通气患儿为研究对象,按照随机数字表法分为经鼻持续气道正压通气(NCPAP)组(102例)和HHHFNC组(109例)。比较两组患儿拔管前平均气道压(MAP)、拔管前吸入氧气浓度(FiO2)、有创呼吸机应用时间和总用氧天数等呼吸参数情况、拔管失败情况、并发症发生情况。结果两组患儿拔管前MAP和有创呼吸机应用时间、拔管前FiO2浓度等呼吸参数情况比较,差异无统计学意义(P>0.05)。HHHFNC组总用氧天数短于NCPAP组,差异有统计学意义(P<0.05)。两组拔管失败率比较,差异无统计学意义(P>0.05)。HHHFNC组患儿不良事件(医院感染、慢性肺疾病)和并发症(腹胀、鼻部损伤)发生率均低于NCPAP组,差异有统计学意义(P<0.05)。结论相比NCPAP方法,HHHFNC的应用更能有效缩短患儿总用氧天数,减少发生并发症、不良反应,对预防新生儿拔管失败更有意义。Objective To explore the effect of heated humidified high flow nasal canula ventilation(HHHFNC)on preventing neonatal extubation failure.Methods From June 2016 to June 2019,a total of 211 children in Neonatal Intensive Care Unit(NICU)of Jiangxi Provincial Children′s Hospital who needed non-invasive assisted ventilation after tracheal intubation were selected as subjects.According to the random number table method,they were divided into nasal continuous positive airway pressure ventilation(NCPAP)group(n=102)and HHHFNC group(n=109).The two groups of children were compared with the average airway pressure(MAP)before extubation,the inhaled oxygen concentration before extubation(FiO2),the application time of the invasive ventilator,total number of oxygen days and other respiratory parameters,the failure of extubation and the occurrence of complications.Results There were no significant differences between the two groups of children before extubation MAP and invasive ventilator application time,FiO2 concentration before extubation and other respiratory parameters,the differences were not statistically significant(P>0.05).Total number of oxygen days of HHHFNC group was shorter than that in NCPAP group,the difference was statistical significance(P<0.05).There was no significant difference in the extubation failure rate between the two groups(P>0.05).The incidence of adverse events(nosocomial infection,chronic lung disease)and complications(abdominal distension,nasal injury)of children in the HHHFNC group were lower than those in the NCPAP group,the differences were statistically significant(P<0.05).Conclusion Compared with the NCPAP method,the application of HHHFNC can effectively shorten the total number of days of oxygen use in children and reduce complications and adverse reactions,and is more meaningful in preventing neonatal extubation failure.

关 键 词：新生儿拔管 加温湿化高流量鼻导管通气 经鼻持续气道正压通气 并发症 

分 类 号：R722[医药卫生—儿科]