HHHFNC和NCPAP治疗早产儿呼吸窘迫综合征的疗效及对心肌损伤指标的影响  

Curative effect of HHHFNC and NCPAP on premature infants with respiratory distress syndrome and their influences on myocardial injury

作　　者：仝实 龚莉 韩梅 柴凤云 朱尚品 TONG Shi;GONG Li;HAN Mei;CHAI Fengyun;ZHU Shangpin(Pediatrics Department,Suining Branch of Xuzhou Medical University Affiliated Hospital(Suining County People's Hospital),Xuzhou,Jiangsu,China,221200)

机构地区：[1]徐州医科大学附属医院睢宁分院(睢宁县人民医院)儿科,江苏徐州221200

出　　处：《分子诊断与治疗杂志》2025年第1期100-103,共4页Journal of Molecular Diagnostics and Therapy

基　　金：江苏省卫生健康委员会(Z2020060)。

摘　　要：目的探讨两种不同无创通气方式治疗早产儿呼吸窘迫综合征(RDS)疗效及对心肌损伤指标的影响。方法回顾性选取2021年1月至2023年12月于徐州医科大学附属医院睢宁分院就诊的118例早产儿RDS的临床资料,根据治疗方法不同分为HHHFNC组51例(加温湿化高流量鼻导管通气)和NCPAP组67例(经鼻持续气道正压通气)。比较两组无创通气时间、开奶时间、总给氧时间、治疗前后血气分析指标[血氧饱和度(SaO_(2))、氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、PH值]、心肌损伤指标[心肌肌钙蛋白Ⅰ(cTnⅠ)、脑钠肽(BNP)、Tei指数],以及治疗后并发症发生情况。结果HHHFNC组无创通气、开奶时间、总给氧时间短于NCPAP组,差异有统计学意义(P<0.05);治疗后,两组PaO_(2)、SaO_(2)、pH值均升高,PaCO_(2)均降低,且HHHFNC组PaO_(2)、SaO_(2)、pH值高于NCPAP组,PaCO_(2)低于NCPAP组,差异有统计学意义(P<0.05);治疗后,两组cTnⅠ、BNP、Tei指数均降低,且HHHFNC组并发症发生率低于NCPAP组,差异有统计学意义(P<0.05);HHHFNC组并发症发生率低于NCPAP组,差异有统计学意义(P<0.05)。结论相比NCPAP,HHHFNC治疗早产儿RDS疗效更佳,其可以缩短无创通气时间和总给氧时间,提早开奶时间,改善血气分析指标,减少心肌损伤和并发症。Objective To explore the curative effect of two non⁃invasive ventilation methods on premature infants with respiratory distress syndrome(RDS)and their influences on myocardial injury.Methods A retrospective collection was performed on the clinical data of 118 premature infants with RDS at the Suining Branch of Xuzhou Medical University Affiliated Hospital from January 2021 to December 2023.According to different treatment methods,premature infants were divided into the heated humidified high flow na⁃sal cannula(HHHFNC)group(51 cases,HHHFNC)and the nasal continuous positive airway pressure(NCPAP)group(67 cases,NCPAP).The non⁃invasive ventilation time,start time of lactation and total oxygen supply time,blood gas analysis indexes(arterial oxygen saturation(SaO_(2)),partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),pH)and myocardial injury indexes(cardiac troponin I(cTnI),brain natriuretic peptide(BNP),Tei index)before and after treatment,and the occurrence of complications after treatment were compared between the two groups.Results The non⁃invasive ventilation time,start time of lactation,and total oxygen supply time in the HHHFNC group were shorter than those in the NCPAP group(P<0.05).After treatment,PaO_(2),SaO_(2)and pH increased in both groups,with higher levels in the HHHFNC group compared to the NCPAP group.Additionally,PaCO_(2)decreased,with lower levels in the HHHFNC group compared to the NCPAP group(P<0.05).Following treatment,cTnI,BNP,and the Tei index decreased in both groups,with lower levels observed in the HHHFNC group compared to the NCPAP group(P<0.05).The incidence of complications in the HHHFNC group was lower than that in the NCPAP group(P<0.05).Conclusion Compared to NCPAP,HHHFNC has a better curative effect on premature infants with RDS.It can shorten non⁃invasive ventilation time and total oxygen supply time,advance the start time of lactation,improve blood gas analysis indexes,reduce myocardial injury,and complications.

关 键 词：呼吸窘迫综合征 早产儿 经鼻持续气道正压通气 加温湿化高流量鼻导管通气 肌钙蛋白Ⅰ 脑钠肽 心脏Tei指数 

分 类 号：R722.6[医药卫生—儿科]