高流量鼻导管氧疗与早产儿呼吸支持

High-flow nasal cannula oxygen therapy and respiratory support in preterm infants

高流量鼻导管氧疗（highflownasalcannulae，HFNC）是一种经充分湿化、加温，流量大于1—2L／min，通过鼻塞外联吸氧管输送高流量混合氧气的无创性呼吸支持模式。在新生儿的应用中，HFNC产生的扩张压与氧流量呈正相关，与新生儿体型呈负相关，同时沿导管泄露氧气也会对其造成影响。HFNC在提高新生儿潮气量、呼吸功等方面与经鼻持续气道正压通气（nasalcontinuouspositiveairwaypressure，nCPAP）可能有相似效果，但仅限于流量低于2L／min的情况下。HFNC可替代CPAP／nCPAP等各类无创通气方法，但在早产儿中推广普及则缺乏更强有力的证据支持。

High flow nasal cannulae（HFNC）, a new mode of noninvasive respiratory support, by highflow nasal cannula transports humidified,warmed and high flow maxed oxygen above the flow of 1 -2 L/rain. In the application of Neonatology, the higher oxygen flow and the smaller body type of newborn cause the stronger the expansion pressure by HFNC, and following the change of the amount of oxygen leaking along the conduit. The effect of HFNC in improving respiratory parameters （ such as neonatal tidal volume and respiratory function） was similar to nasal continuous positive airway pressure （NCPAP）, but the effectiveness is limited to the flow less than 2L/min. A growing number of evidence suggests that HFNC as an alternative method for preterm non-invasive alternative ventilation is available, but the effect and safety of applications in preterm still need further research. HFNC is not recommended popularized in preterm until more randomized trials to confirm.