高流量吸氧与CPAP在儿童先心病术后严重I型呼吸衰竭中支持作用的比较

Comparison between High-flow Nasal Cannula and CPAP in Post-operative Congenital Heart Disease Children with Severe Type I Respiratory Failure

目的:比较高流量吸氧(HFNC)与CPAP在儿童先心病术后严重I型呼吸衰竭中的支持作用,提供更合理的支持方案。方法:将我科2018年1月至2018年12月收治的44例先心病术后撤离呼吸机后出现严重I型呼吸衰竭的病例按照均衡随机化分组的方法随机分为HFNC组(22例)和CPAP组(22例),比较两组患儿的动脉氧分压(PaO2)、经皮血氧饱和度(SpO2)、动脉二氧化碳分压(PaCO2)、呼吸频率(RR)、呼吸做功评分(RW评分)、再插管率、有创通气时间、ICU滞留时间、住院时间及舒适度评分、鼻压伤、腹胀、返流误吸、气漏的发生率有无差异。结果:HFNC组与CPAP组比较,PaO2、SpO2、再插管率、有创通气时间、ICU滞留时间、住院时间、气漏发生率无统计学差异;PaCO2、RR、RW评分、舒适度评分及鼻压伤、腹胀、返流误吸的发生率低于CPAP组,有统计学差异。结论:比较对儿童先心病术后严重I型呼吸衰竭患者的支持作用,HFNC优于CPAP。

Objective:To Compare the difference between the support effects of high-flow nasal cannula(HFNC)and CPAP in post-operative congenital heart disease(CHD)children with severe type I respiratory failure.Methods:From January 2018 to December 2018,44 children were treated with HFNC(22 cases)and CPAP(22 cases)for severe type I respiratory failure after operation of congenital heart disease.PaO2,SpO2,PaCO2,RR,RW score,duration of invasive ventilation,reintubation rate,duration of ICU,hospital stay,comfort score,nasal crush,abdominal distention,regurgitation and aspiration,gas leakage are compared between the two groups.Results:Comfort score,PaCO2,RR,RW score,nasal crush,abdominal distention,regurgitation and aspiration was lower in the HFNC group.There were no statistical significance in PaO 2,SpO2,duration of invasive ventilation,reintubation rate,duration of ICU,hospital stay and gas leakage between the two groups.Conclusion:Comparing the support to post-operative children with CHD and severe type I respiratory failure,HFNC is better than CPAP.