HHFNC与nCPAP治疗早产低出生体重儿呼吸暂停的疗效比较

Comparison of Humidified High Flow Nasal Cannula(HHFNC) and nasal Continuous Positive Airway Pressure (nCPAP) in the Treatment of Apnea in Preterm Infants

目的:比较湿化高流量鼻导管通气(humidified high flow nasal cannula,HHFNC)与鼻塞式持续气道正压通气(nasal continuous positive airway pressure,CPAP)治疗早产低出生体重儿呼吸暂停的临床疗效。方法:2015年6~12月在本院新生儿科收治的呼吸暂停早产低出生体重儿共90例,随机分为HHFNC组和n CPAP组。前者在药物治疗基础上行湿化高流量鼻导管通气治疗,后者采用n CPAP通气支持。结果:HHFNC组总有效率明显高于n CPAP组,差异有统计学意义(P<0.05)。两组因频繁呼吸暂停需重新辅助机械通气支持的例数比较差异无统计学意义(P>0.05)。n CPAP组中出现鼻损伤、腹胀病例明显多于HHFNC组(P<0.05)。两组在呼吸道感染发生率比较差异无统计学意义(P>0.05)。结论:HHFNC能有效改善早产低出生体重儿呼吸暂停,且HHFNC对患儿的损伤更小,易被患儿接受,值得推广。

Objective To compare the clinical efficacy of humidified high flow nasal cannula（ HHFNC） and nasal continuous positive airway pressure（ CPAP） in the treatment of apnea in low birth weight preterm infants. Methods 90 preterm infants diagnosed with neonatal apnea in our hospital from June 2015 to December 2015 were randomly divided into the HHFNC group and the n CPAP group. The infants in HHFNC group were treated with humidified high-flow nasal cannula therapy on the basis of drug therapy,and the infants in n CPAP group were treated by CPAP aerating the congested nose on the basis of drug therapy. Results The total effective rate of the HHFNC group was obviously higher than that of the n CPAP group,which was significantly different（ P0.05）. There were no statistically significant differences between the two groups in the need for re-support of mechanical ventilation due to apnea（ P0.05）.The incidences of nasal injury and abdominal distension in the n CPAP group were obviously more than those in the HHFNC group,and the difference was significantly different（ P0.05）.There was no significant difference in incidence of the respiratory tract infection between the two groups（ P0.05）. Conclusion HHFNC can effectively improve apnea in low birth weight preterm infants. HHFNG is worth popularizing because it has less damage and is easy to be accepted by children.