论文部分内容阅读
目的:探讨湿化高流量鼻导管通气(HHFNC)治疗极低出生体质量儿呼吸暂停的效果。方法:选取住院期间出现呼吸暂停的极低出生体质量儿作为研究对象,在使用枸橼酸咖啡因的基础上,随机分为两组,HHFNC组给予湿化高流量鼻导管通气,n CPAP组给予经鼻持续正压通气,比较两组间动脉血气分析变化、治疗有效率、尿量、血压的改变及无创机械通气时间、并发症的发生率。结果:经治疗后两组氧合均明显改善;HHFNC组在治疗6 h、12 h、24 h、48 h后二氧化碳分压的改善情况优于n CPAP组(Ffactor=14.253,P<0.01),且鼻黏膜的损伤、喂养不耐受的发生率较n CPAP组低(P<0.05);HHFNC组治疗后尿量增加(P<0.01);两组有效率比较差异无统计学意义(P>0.05);两组无创机械通气时间、气漏、低血压、新生儿坏死性小肠结肠炎、脑损伤(颅内出血、早产儿脑室周白质软化)、支气管肺发育不良发生率比较差异均无统计学意义(P>0.05)。结论:HHFNC可作为一种有效的无创呼吸支持模式治疗早产儿呼吸暂停,喂养不耐受及鼻黏膜损伤发生率相对较低,可提高治疗的耐受性。
Objective: To investigate the effect of humidified high flow nasal catheter ventilation (HHFNC) on apnea of very low birth weight children. Methods: Very low birth weight children with apnea during hospitalization were selected as study subjects. They were randomly divided into two groups on the basis of caffeine citrate infusion. HHFNC group was given humidification high-flow nasal catheter ventilation, n CPAP group Nasal continuous positive pressure ventilation was given to compare changes in arterial blood gas analysis between the two groups, the treatment efficiency, urine output, blood pressure changes and non-invasive mechanical ventilation time, the incidence of complications. Results: Oxygenation was significantly improved in both groups after treatment. The improvement of partial pressure of carbon dioxide in HHFNC group was better than n CPAP group (Ffactor = 14.253, P <0.01) at 6 h, 12 h, 24 h and 48 h after treatment, The incidence of nasal mucosa injury and feeding intolerance was lower than that of n CPAP group (P <0.05), and the urine output of HHFNC group was increased after treatment (P <0.01). There was no significant difference in the effective rate between the two groups (P> 0.05). There was no significant difference in the incidence of non-invasive mechanical ventilation, air leak, hypotension, neonatal necrotizing enterocolitis, brain injury (intracranial hemorrhage, periventricular leukomalacia) and bronchopulmonary dysplasia Significance (P> 0.05). CONCLUSIONS: HHFNC can be used as an effective noninvasive respiratory support model for the treatment of apnea in preterm infants, with a relatively low incidence of feeding intolerance and nasal mucosal injury, and improved tolerability of treatment.