湿化高流量鼻导管通气预防超低出生体质量儿拔管失败临床分析

Clinical Study on the Prevention of Extubation Failure of Ultra Low Birth Weight Infants by Wetting High Flow Nasal Catheter Ventilation

目的:探讨湿化高流量鼻导管通气预防超低出生体质量儿拔管失败的临床效果。方法:收集2015年1月至2016年7月梅州市人民医院新生儿重症监护病房收治的超低出生体质量儿36例的病历资料,患儿生后均经气管插管接呼吸机辅助呼吸,撤机拔管后按随机数字表法分为两组,对照组16例,采取鼻塞式持续气道正压通气治疗(NCPAP),观察组20例,采取湿化高流量经鼻导管通气治疗(HHFNC),观察并比较两组患儿治疗7 d内拔管失败率、并发症发生率及通气治疗时间。结果:两组患儿治疗7 d内拔管失败率、通气治疗时间及肺气漏、支气管肺发育不良发生率比较,无统计学差异(P>0.05),观察组鼻损伤、腹胀发生率明显低于对照组(P<0.01)。结论:湿化高流量鼻导管通气能有效预防超低出生体质量儿拔管失败,同时降低鼻损伤、腹胀发生率,提高患儿舒适感。

Objective To probe into the clinical effects of humidified high flow therapy via nasal cannula in preventing the failure of extremely low birth weight infants.Methods Case history data of 36 cases of extremely low birth weight infants and who get into neonatal intensive care unit within 7d after birth in our hospital from January,2015 to January,2016 were collected,and were divided into two groups according to the random number table methods.In the control group of 16 cases were taken nasal continuous positive airway pressure while in the observation group of 20 cases were treated with humidified high flow via nasal cannula.Then,the clinical effect,weaning failure rate and the incidence of complications of two groups were compared.Results The extubation failure rate after treatment for 7d,ventilation time and lung leakage,incidence rate of bronchopulmonary dysplasia of two groups of patients had no statistical difference(P > 0.05),and the nasal injury and the incidence rate of abdominal distension in the observation group were significantly lower than that in the control group(P < 0.01).Conclusion The humidified high flow therapy via nasal cannula can effectively prevent the failure of extremely low birth weight infants,and can reduce the incidence of nasal injury,abdominal distension,improve the comfort of patients.