湿化高流量鼻导管辅助通气治疗早产儿呼吸窘迫综合征的临床效果

Clinical efficacy of respiratory support with humidified high-flow nasal cannula for preterm infants with respiratory distress syndrom

目的探讨湿化高流量鼻导管辅助通气(HHFNC)治疗早产儿呼吸窘迫综合征(RDS)的疗效和安全性。方法将100例RDS早产儿随机分为鼻塞式持续性气道正压通气(NCPAP)组和HHFNC组,每组50例。两组均给予常规治疗,并给予相应的通气方法。比较两组患儿通气前和通气48 h后PaO_2、PaCO_2及血氧饱和度(SaO_2),以及无创通气时间、重新气管插管率、并发症发生率。结果治疗48 h后,两组患儿PaO_2、SaO_2均高于治疗前,PaCO_2低于治疗前(均P<0.05),且HHFNC组PaO_2高于NCPAP组,PaCO_2低于NCPAP组(均P<0.05);两组患儿无创通气时间、重新气管插管率比较,差异均无统计学意义(P>0.05);HHFNC组患儿鼻部损伤、腹胀发生率低于NCPAP组(P<0.05)。结论 HHFNC有助于改善RDS早产儿的血气指标,提高患儿的通气功能,降低并发症发生率。

Objective To investigate the efficacy and safety of respiratory support with humidified high-flow nasal cannula(HHFNC)for preterm infants with respiratory distress syndrome(RDS).Methods A hundred preterm infants with RDS were randomly divided into nasal continuous positive airway pressure(NCPAP)group and HHFNC group,with 50 cases in each group.The two groups received conventional therapy and corresponding respiratory support therapy.PaO 2,PaCO 2 and oxygen saturation(SaO 2)before ventilation and after 48 hours of ventilation were compared between the two groups.The duration for noninvasive ventilation,the reintubation rate and the incidence rate of complications were also compared between the two groups.Results After 48 hours of treatment,PaO 2 and SaO 2 levels were higher and PaCO 2 levels were lower in both groups compared to the levels before treatment(all P<0.05),and PaO 2 level was higher and PaCO 2 level was lower in the HHFNC group compared to the levels in the NCPAP group(all P<0.05);there were no significant differences in the duration for noninvasive ventilation or reintubation rate between the two groups(P>0.05);the incidence rates of nasal injury and abdominal distension in the HHFNC group were lower than those in the NCPAP group(P<0.05).Conclusion HHFNC is benefit to improving the blood gas index and ventilation function of preterm infants with RDS and can reduce the incidence rate of complications.