摘要
目的比较无创高频振荡通气(noninvasive high-frequency oscillatory ventilation,NHFOV)和经鼻持续气道正压通气(nasal continuous positive airway pressure, NCPAP)作为胎龄26+0周~31+6周早产儿有创机械通气拔管后无创呼吸支持的疗效。方法收集2017年1月至2019年1月九龙坡区人民医院新生儿科和重庆医科大学附属儿童医院新生儿诊疗中心收治的早产儿114例,通过抽取信封法随机分成两组:治疗组接受NHFOV治疗(n=56);对照组接受NCPAP治疗(n=58例)。主要评价指标是两组早产儿在撤离有创机械通气后7 d内无创通气失败需要再次气管插管的比例,次要评价指标包括无创通气支持时间、住院天数和住院死亡、气胸、校正胎龄36周或离院时支气管肺发育不良(bronchopulmonary dysplasia,BPD)、坏死性小肠结肠炎(necrotizing enterocolitis,NEC)、颅内出血(intracranial hemorrhage,IVH)发生情况。结果在撤离有创机械通气后7 d内无创通气失败需要再次气管插管的比例方面,NHFOV组明显低于NCPAP组(14.2%vs 31.0%,P=0.033);两组次要评价指标比较差异均无统计学意义。结论与NCPAP比较,NHFOV作为早产儿有创机械通气拔管后无创呼吸支持可以提高撤机成功率,减少再次气管插管。
Objective To compare the efficacy of non-invasive high-frequency oscillatory ventilation(NHFOV) with nasal continuous positive airway pressure(NCPAP) in preterm infants aged 26+0~31+6 weeks as post-extubation respiratory support. Methods A total of 114 infants admitted to Department of Neonatology, Jiulongpo District People’s Hospital and Diagnosis and Treatment Center for Neonates of Children’s Hospital of Chongqing Medical University during January 2017 to January 2019 were recruited, and randomized to NCPAP group(n=58, control) and NHFOV group(n=56) by envelope extraction. The primary outcomes were treatment failure and need for re-intubation within 7 d after extubation. Secondary outcomes included duration of noninvasive ventilation, length of hospitalization, mortality, and incidences of pneumothorax, bronchopulmonary dysplasia(BPD) at 36 weeks of postmenstrual age or discharge, intracranial hemorrhage(IVH) and necrotizing enterocolitis(NEC). Results The rate of treatment failure and need for re-intubation within 7 d after extubation was significantly lower in the NHFOV group than the NCPAP group(14.2% vs 31.0%, P=0.033). There were no statistically differences in all other secondary outcomes between the 2 groups. Conclusion NHFOV can improve the success rate of weaning and reduce the need for re-intubation as compared with NCPAP in preterm infants after extubation.
作者
李欢欢
朱兴旺
汪万军
LI Huanhuan;ZHU Xingwang;WANG Wanjun(Department of Neonatology, Jiulongpo District People's Hospital, Chongqing, 400000;Diagnosis and Treatment Center for Neonates, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2019年第17期1688-1692,共5页
Journal of Third Military Medical University
关键词
早产儿
无创高频振荡通气
经鼻持续气道正压通气
preterm infants
non-invasive high-frequency oscillatory ventilation
nasal continuous positive airway pressure
