不同辅助通气方式预防极低出生体重早产儿拔管失败的临床分析

Clinical Analysis of Different Auxiliary Ventilation Methods to Prevent Extubation Failure in Very Low Birth Weight Premature Infants

目的探究不同辅助通气方式预防极低出生体重早产儿拔管失败的临床效果分析。方法选取我院新生儿科自2016年12月至2017年12月收治的极低出生体重早产儿(胎龄34周、体重<1500g)110例分别采用加温湿化经鼻导管高流量通气(HHHFNC),同时采用鼻塞式持续气道正压通气(NCPAP),观察组的患儿采用NCPAP,治疗组患儿采用HHHFNC。记下并对比两类患儿的总用氧时间、有创通气时间、无创通气时间、拔管失败率等并发症发生率。结果治疗组有创通气时间、总用氧时间分别为(6.52±3.03)d、(19.06±5.42)d,与观察组相比较低(P<0.05),两组无创通气时间和拔管未成功的概率相比较结果具有相似性(P>0.05),相比较观察组,鼻部不易受损害,也不容易出现腹胀等现象。结论 HHHFNC可明显减少极低出生体重早产儿有创通气的时间,并能有效克制拔管未成功等其他一些病状,临床上的应用效果比较客观。

Objective To explore the clinical effect of different auxiliary ventilation methods to prevent the failure of premature birth weight. Methods Choose our new pediatric since December 2016 to December 2017 were of very low birth weight premature infants（gestational age 34 weeks, weight1500 g） 110 cases, respectively, using high flow ventilation plus temperature humidity to nasal catheter（HHHFNC） and nasal continuous positive airway pressure（NCPAP）, observation group with NCPAP, treatment group with HHHFNC. The incidence of complications such as total oxygenation time, invasive ventilation time, non-invasive ventilation time, and failure rate of tube extraction were recorded and compared. Results Treatment group with the ventilation time and total time（6.52±3.03） respectively with oxygen d,（19.16±5.52）d, compared with the observation group was significantly lower（P〈0.05）, two groups of noninvasive ventilation time and extubation failure rate is no statistical significance（P〈0.05）, nasal injury, gas leakage, the incidence of complications such as abdominal distension and observation group is significantly lower. Conclusion High flow ventilation plus temperature humidity to nasal catheter can obviously shorten the extremely low birth weight premature infants have a ventilation time, and can effectively prevent complications such as extubation failure, has good clinical effect.