加温加湿高流量鼻导管吸氧对预防早产儿支气管肺发育不良的研究

Study on the Prevention of Bronchopulmonary Dysplasia in Premature Infants by High Flow Nasal Catheter Oxygen Inhalation

目的探讨加温加湿高流量鼻导管吸氧对预防早产儿支气管肺发育不良(BPD)的作用。方法入选惠州市中心人民医院NICU,且符合研究标准需机械通气的早产儿150例,按随机数字表法分为3组,分别给予加温加湿高流量鼻导管吸氧、经鼻间歇正压辅助通气和鼻塞式持续气道正压通气。记录3组早产儿是否发生支气管肺发育不良,住院时间,是否发生鼻中隔损伤、腹胀、喂养不耐受和院内感染。结果150例早产儿中BPD发病率为36.7%,给予加温加湿高流量鼻导管吸氧的早产儿BPD的发生率为20.0%,经鼻间歇正压辅助通气组为48.0%,鼻塞式持续气道正压通气组为42.0%,差异具有统计学意义(P<0.05)。加温加湿高流量鼻导管吸氧组早产儿鼻中隔损伤、腹胀、喂养不耐受和院内感染的发生率更低,差异具有统计学意义(P<0.05)。结论临床上治疗早产儿呼吸困难时可应用加温加湿高流量鼻导管吸氧,降低支气管肺发育不良的发生率,提高早产儿的生活质量。

Objective To investigate the effect of warm-humidifying high-flow nasal catheter oxygen inhalation on the prevention of bronchopulmonary dysplasia in premature infants.Methods A total of 150 cases of preterm infants who met the research criteria,were enrolled in the NICU of the hospital and required mechanical ventilation were divided into three groups according to the random number table method.The incidence of bronchopulmonary dysplasia,length of hospital stay,septal injury,abdominal distension,feeding intolerance and nosocomial infection were recorded in the three groups.Results Among the 150 premature infants,the inci dence of BPD was 36.7%,the incidence of bronchopulmonary dysplasia was 20.0%in the preterm infants who were given warm and moist nasal catheter with high flow of oxygen,in the group of nasal intermittent was 48.0%,and in the group of nasal obstruction con tinuous positive airway pressure ventilation was 42.0%.The difference was statistically significant(P<0.05).The incidence of nasal septum injury,abdominal distension,feeding intolerance and nososoial infection was lower in the preterm infants in the high-flow na sal catheter oxygen group with heating and humidification,with significant difference(P<0.05).Conclusion In the clinical treatment of premature infants with dyspnea,high flow nasal catheter oxygen can be used to reduce the incidence of bronchial and pulmonary dysplasia,and improve the quality of life of premature infants.