无创高频振荡通气联合枸橼酸咖啡因对胎龄28~32周早产儿有创机械通气撤机后呼吸支持的研究  

Study on non-invasive high-frequency oscillatory ventilation combined with caffeine citrate for respiratory support in premature infants with a gestational age of 28-32 weeks after being weaned from invasive mechanical ventilation

作　　者：王彦波 赵亮 李丽[1] 孙中怡 张心 王云[1] 刘枭 吴杰斌[1] 周彬[1] WANG Yanbo;ZHAO Liang;LI Li;SUN Zhongyi;ZHANG Xin;WANG Yun;LIU Xiao;WU Jiebin;ZHOU Bin(Department of Pediatrics,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China;Xuzhou Clinical College,Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]江苏省徐州市中心医院儿科,221009 [2]徐州医科大学徐州临床学院,江苏徐州221000

出　　处：《重庆医学》2023年第15期2335-2339,共5页Chongqing medicine

基　　金：江苏省徐州市科技项目(KC18185)。

摘　　要：目的分析无创高频振荡通气(NHFOV)联合枸橼酸咖啡因对胎龄28~32周早产儿有创机械通气撤机后呼吸支持的影响。方法选取2020年10月至2022年9月徐州市中心医院收治的109例胎龄28~32周早产儿为研究对象,根据治疗方法分为观察组(接受NHFOV联合枸橼酸咖啡因治疗,n=36)、经鼻持续气道正压通气(NCPAP)组(接受NCPAP联合枸橼酸咖啡因治疗,n=41)和对照组(接受NCPAP治疗,n=32)。比较3组治疗效率指标(治疗时间、开始接受肠内营养时间、住院时间)、血气指标[氧分压(PO_(2))、二氧化碳分压(PaCO_(2))、氧合指数(OI)]、二次气管插管率、呼吸暂停(AOP)发生率、死亡率及并发症发生率。结果观察组无创通气时间、开始肠内营养时间、整体住院时间较NCPAP组和对照组缩短,差异有统计学意义(P<0.05)。治疗后24 h 3组PO_(2)、OI上升,PaCO_(2)下降,且观察组PO_(2)、OI最高,PaCO_(2)最低,差异有统计学意义(P<0.05)。观察组二次插管率和AOP发生率低于NCPAP组和对照组,差异有统计学意义(P<0.05)。3组死亡率比较,差异无统计学意义(P>0.05)。12例(11.01%)患儿发生并发症,3组并发症总发生率比较,差异无统计学意义(P>0.05)。结论NHFOV联合枸橼酸咖啡因可提高早产儿呼吸支持效率。Objective To examine the impact of combining non-invasive high-frequency oscillatory ventilation(NHFOV)with caffeine citrate on respiratory support in premature infants with a gestational age of 28-32 weeks,after they have been weaned from invasive mechanical ventilation.Methods A total of 109 premature infants with a gestational age of 28-32 weeks were selected as the research subjects.These infants were admitted to Xuzhou Central Hospital from October 2020 to September 2022.According to the treatment method,the participants were divided into three groups:the observation group(n=36),who received NHFOV combined with caffeine citrate;the nasal continuous positive airway pressure(NCPAP)group(n=41),who received NCPAP combined with caffeine citrate;and the control group(n=32),who received NCPAP treatment alone.The study compared various factors among the three groups,including the treatment efficiency index(duration of treatment,initiation of enteral nutrition,length of hospital stay),blood gas index[oxygen partial pressure(PO_(2)),carbon dioxide partial pressure(PaCO_(2)),oxygenation index(OI)],secondary tracheal intubation rate,incidence of apnea(AOP),mortality rate,and complication rate.Results The duration of non-invasive ventilation,the time of initiation of enteral nutrition,and the overall length of hospital stay were shorter in the observation group compared to both the NCPAP group and the control group.These differences were found to be statistically significant(P<0.05).24 h after treatment,the levels of PO_(2) and OI increased,while PaCO_(2) decreased in all three groups.The observation group showed the highest PO_(2) and OI,as well as the lowest PaCO_(2).These differences were found to be statistically significant(P<0.05).The re-intubation rate and the incidence of AOP were lower in the observation group compared to the NCPAP group and the control group,and this difference was statistically significant(P<0.05).There was no significant difference in mortality among the three groups(P>0.05).Complications occ

关 键 词：无创高频振荡通气 枸橼酸咖啡因 早产儿 有创机械通气 呼吸支持 

分 类 号：R181.32[医药卫生—流行病学]