高流量鼻导管与持续气道正压通气治疗极低出生体质量儿的疗效分析

Humidified heated high flow nasal cannula versus nasal continuous positive airway pressure for initial respiratory support of very low birth weight infants

目的评价极低出生体质量儿生后早期应用高流量鼻导管通气的安全性及有效性。方法 106例28~32周符合纳入标准的极低出生体质量儿随机分为2组,一组给予高流量鼻导管通气(HHHFNC)治疗,另一组给予经鼻持续气道正压通气(NCPAP)治疗。主要评价指标为呼吸系统结局和并发症的发生率。结果共分析98例数据,HHHFNC组在鼻损伤发生率上较NCPAP组低(2.0%vs 14.6%,P=0.029),差异有统计学意义。两组在其他各项指标上差异均无统计学意义(P>0.05)。结论 28~32周胎龄极低出生体质量儿生后早期采用HHHFNC与NCPAP相比同样有效,但其安全性更好。

Objective To assess the efficacy and safety of humidified heated high flownasal cannula（ HHHFNC） compared with nasal continuous positive airway pressure（ NCPAP） for the initial respiratory support of very lowbirth weight（ VLBW） infants. Methods A total of 106 VLBW infants with gestational age（ GA） between 28-32 weeks who met the predefined criteria for noninvasive ventilation were randomized to either the HHHFNC group or NCPAP group. The evaluation indexes included the respiratory outcomes and the incidence of complications. Results The clinical data of 98 infants were analyzed. The incidence of nasal trauma was significantly lower in the HHHFNC group than in the NCPAP group（ 2.0% vs 14.6%,P = 0.029）. There were no differences in the other respiratory and clinical outcomes between the two groups（ P〉0.05）. Conclusion Compared to NCPAP,HHHFNC appears to be safer while has a similar efficacy as an initial respiratory support in VLBW infants with GA between 28-32 weeks.