摘要
目的探讨无创高频振荡通气(NHFOV)对早产儿脑组织氧合的影响。方法回顾性分析2019年1月至2020年1月出生后24 h内出现呼吸窘迫并入住医院新生儿重症监护室(NICU)、以无创通气(NIV)进行初始呼吸支持治疗的171例早产儿的病历资料,按照治疗方法的不同分为对照组(114例)和试验组(57例)。试验组采用NHFOV治疗,对照组采用双水平正压通气(BiPAP)治疗,比较两组治疗后脑局部组织氧饱和度(CrSO_(2))、脑摄氧分数(CFTOE)、经皮氧分压(TcPO_(2))、经皮二氧化碳分压(TcPCO_(2))及临床结果。结果接受NIV治疗后0.5、2 h,试验组CrSO_(2)均高于对照组,但差异无统计学意义(P>0.05);接受NIV治疗后4 h,试验组CrSO_(2)高于对照组,差异有统计学意义(P<0.05);接受NIV治疗后0.5、2、4 h,试验组CFTOE均低于对照组,差异有统计学意义(P<0.05);接受NIV治疗后0.5、2、4 h,试验组TcPO_(2)均高于对照组,差异有统计学意义(P<0.05);接受NIV治疗后0.5、2、4 h,试验组TcPCO_(2)均低于对照组,差异有统计学意义(P<0.05);试验组NIV治疗成功率高于对照组,差异有统计学意义(P<0.05);接受NIV治疗后,两组气漏综合征发生率、脑室内出血(IVH)≥2级占比、脑室周围白质软化(PVL)发生率、住院期间死亡发生率比较,差异均无统计学意义(P>0.05)。结论与BiPAP治疗相比,NHFOV对早产儿进行初始无创呼吸支持的技术是有效和安全的,可提高患儿脑组织氧合,降低气管插管率,减少CO_(2)潴留,且不增加气漏综合征、IVH、PVL等并发症发生风险及死亡风险。
Objective To investigate the effect of noninvasive high frequency oscillating ventilation(NHFOV)on the cerebral oxygen saturation of premature infants.Methods A retrospective analysis was performed on the medical records of 171 premature infants who developed respiratory distress within 24 hours after birth and were admitted to the neonatal intensive care unit(NICU)for initial respiratory support therapy with noninvasive ventilation(NIV)from January 2019 to January 2020.According to different treatment methods,they were divided into control group(114 cases)and experimental group(57 cases).The experimental group received NHFOV,and the control group received biphasic positive airway pressure(BiPAP).The cerebral regional oxygen saturation(CrSO_(2)),cerebral fractional tissue oxygen extraction(CFTOE),partial percutaneous oxygen pressure(TcPO_(2)),partial percutaneous carbon dioxide pressure(TcPCO_(2))and clinical outcomes after ventilatory treatment were compared between the two groups.Results The CrSO_(2)of the experimental group was higher than the control group at 0.5 and 2 hours after NIV treatmented,but the difference was not statistically significant(P>0.05).The CrSO_(2)was higher in the experimental group than the control group at 4 hours after NIV treatmented(P<0.05).The CFTOE and the TcPCO_(2)were lower in the experimental group than the control group(P<0.05).The TcPO_(2)was higher in the experimental group than the control group at 0.5,2,and 4 h after NIV treatmented(P<0.05).The success rate of NIV treatment in the experimental group was higher than that in the control group(P<0.05).There was no difference in the rate of air leakage syndrome,intraventricular hemorrhage(IVH)≥2 grade,periventricular leukomalacia(PVL)and death between the two groups(P>0.05).Conclusion This study shows that NHFOV is effective and safe for initial noninvasive respiratory support in premature infants by compared to BiPAP,which can improved cerebral oxygenation,reduced the rate of endotracheal intubation and CO_(2)retention,with
作者
赖淑华
郑歆婷
刘素佳
林水娣
林云峰
Lai Shuhua;Zheng Xinting;Liu Sujia;Lin Shuidi;LinYunfeng(Fujian Maternity and Child Health Hospital,Affiliated Hospital of Fujian Medical University,Fuzhou Fujian 350001,China)
出处
《医疗装备》
2022年第4期1-4,共4页
Medical Equipment
关键词
脑局部组织氧饱和度
脑摄氧分数
无创高频振荡通气
双水平正压通气
早产儿
Cerebral regional oxygen saturation
Cerebral fractional tissue oxygen extraction
Noninvasive high frequency oscillatory ventilation
Biphasic positive airway pressure
Preterm infants
