摘要
目的对比并评价加温湿化经鼻导管高流量通气(HHHFNC)和鼻塞式持续气道正压通气(NCPAP)两种辅助通气方式治疗极低出生体重儿呼吸窘迫综合征(RDS)的临床疗效。方法选择89例患有RDS的极低出生体重(<1 500 g)新生儿作为研究对象,所有患儿均给予常规治疗,将其随机分为两组,H组(n=44)采用HHHFNC方式治疗,N组(n=45)采用NCPAP方式治疗,比较两组患儿的临床症状改善情况以及并发症与转归情况。结果 H组的腹胀率、开奶时间、达到全肠道喂养时间、有创辅助通气时间、总用氧时间、7 d内重新插管率均要优于N组(P<0.05);H组的鼻部损伤率、气漏发生率显著低于N组(P<0.05),但两组患儿其余并发症发生率差异无统计学意义(P>0.05)。结论 HHHFNC在耐受性、相关损伤发生率方面要优于鼻塞式持续气道正压通气NCPAP,对于极低出生体重RDS患儿建议优先采用HHHFNC方式进行治疗。
ObjectiveTo compare and evaluate the clinical efficacy of application of high flow ventilation plus warm humidity through nasal catheter(HHHFNC)and nasal continuous positive airway pressure(NCPAP)two kinds of auxiliary ventilation in treatment of respiratory distress syndrome(RDS)in neonates with extremely low birth weight.MethodsA total of89neonatal patients with RDS and very low birth weight(<1500g)were selected as study objects,all these children were given with conventional treatment,and they were randomly divided into two groups.Patients in group H(n=44)were using HHHFNC for treatment,and patients in N group(n=45)were applied with NCPAP therapy.The improvement in clinical symptoms,the incidence of complications and outcome were cmpared between these2groups of children.ResultsThe incidence rate of abdominal distention,the time for starting drinking milk,and the time for reaching full intestine,the time for auxiliary ventilation,total duration for oxygen supply,and re-intubation times within7d in H group were better than those of N group(P<0.05),but the difference in duration for need of assistant ventilation,time for noninvasive assistant ventilation,rate for3d intubation,and the second time in PS utilization among childrenm in these2groups had no statistical significance(P>0.05).The rates of nasal injury and gas leakage in group H were significantly lower than those of N group(P<0.05),but the difference in intracranial hemorrhage,softening of cerebral white matter,enterocolitis,premature diseases,unclosed retinal arterial catheter and the incidence of bronchial pulmonary dysplasia was not statistically significant(P>0.05).ConclusionThe tolerance and incidenc of related injury in HHHFNC are better than those with nasal type continuous positive airway pressure(NCPAP).For children with very low birth weight suffered with RDS,we prefer to take HHHFNC for treatment.
作者
张纪华
闫俊梅
丁玉红
ZHANG Ji-hua;YAN Jun-mei;DING Yu-hong(Neonatal Medical Center, Maternal and Child Health Care Hospital, Affiliated to Xuzhou Medical University, Xuzhou Jiangsu 221000, China.)
出处
《临床和实验医学杂志》
2017年第23期2375-2378,共4页
Journal of Clinical and Experimental Medicine
基金
江苏省妇幼健康科研项目(编号:F201552)
关键词
极低出生体重儿
呼吸窘迫综合征
加温湿化经鼻导管高流量通气
鼻塞式持续气道正压通气
并发症
临床转归
Extremely low birth weight children
Respiratory distress syndrome
High flow ventilation plus temperature humidity to nasal catheter
Nasal continuous positive airway pressure
Complications
Clinical outcome
