摘要
目的探讨加温湿化高流量鼻导管吸氧在新生儿机械通气撤机后的效果。方法选择2018年1月至2019年3月在本院新生儿重症监护室(neonatal intensive care unit,NICU)治疗的早产儿54例为研究对象。撤机后,将患儿随机分为两组,即观察组28例(HHFNC治疗)和对照组26例(NCPAP治疗)。将两组患儿动脉血气、治疗效果、撤机失败原因和不良反应发生率进行对比分析。结果与治疗后1 h比较,撤机后治疗12、24 h的PaO2、PaCO2、a/APO2明显改善(P<0.05),两组患儿1、12、24 h的3项指标比较差异无统计学意义。撤机后,两组患儿无创辅助通气时间、总吸氧时间、达全肠道营养时间、总住院时间等比较,差异具有统计学意义(P<0.05)。对照组撤机失败率为7.1%,观察组为10.7%,两组撤机失败率差异无统计学意义。与对照组比较,在撤机后,观察组患儿鼻损伤、腹胀率明显更低(P<0.05)。观察组和对照组患儿PDA和气漏等其他并发症发生率比较差异无统计学意义。结论撤机后,与NCPAP相比较,HHFNC可以减小对患儿身体的损伤,安全性更好。
Objective To investigate the effect of warming and humidifying high-flow nasal cannula on oxygen in the neonatal mechanical ventilation.Methods A total of 54 preterm infants who were treated with neonatal intensive care unit(NICU)from January 2018 to March 2019 were enrolled.After weaning,the children were randomLy divided into two groups,namely,28 patients in the observation group(HHFNC treatment)and 26patients in the control group(NCPAP treatment).The arterial blood gas,treatment effect,cause of weaning failure and incidence of adverse reactions were compared between the two groups.Results Compared with 1 h after treatment,PaO2,PaCO2 and a/APO2 were significantly improved after 12 and 24 hours of treatment(P<0.05).There was no significant difference in the three indexes between 1,12 and 24 hours.After weaning,the two groups of children with non-invasive assisted ventilation time,total oxygen inhalation time,total intestinal nutrition time,total hospitalization time,the difference was statistically significant(P<0.05).The failure rate of the control group was 7.1%,and that of the observation group was 10.7%.There was no significant difference in the rate of failure between the two groups.Compared with the control group,after the weaning,the incidence of nasal injury and abdominal distension in the observation group was significantly lower(P<0.05).There was no significant difference in the incidence of other complications such as PDA and air leak between the observation group and the control group.Conclusion After weaning,HHFNC can reduce the damage to the child’s body compared with NCPAP,and the safety is better.
作者
刘盼丽
罗宏斌
廖志伟
杨瑞芬
刘卫云
胡渝
肖小星
胡敏
Liu Panli;Luo Hongbin;Liao Zhiwei;Yang Ruifen;Liu Weiyun;Hu Yu;Xiao Xiaoxing;Hu Min(Department of Neonatology,Xinyu People's Hospital,Xinyu,Jiangxi,338025,China;Medical Office of the Retired Service Center of Xinyu City,Xinyu,Jiangxi,338025,China)
出处
《当代医学》
2020年第1期101-103,共3页
Contemporary Medicine
基金
新余市科技计划项目（20173090819)
