高流量鼻导管通气在早产儿呼吸暂停中的临床应用

Clinical Application of High Flow Nasal Catheter Ventilation in Apnea of Premature Infants

目的探讨高流量鼻导管通气(HFNC)在早产儿呼吸暂停中的应用效果。方法选取2016年6月—2019年6月于医院分娩并诊断为呼吸暂停的40例早产儿作为研究对象,采用随机数字表法进行随机化分组,分为观察组和对照组各20例,对照组采用持续呼吸道正压通气(nCPAP),观察组采用高流量鼻导管通气。观察比较两种治疗方法的治疗效果,以及两组患儿通气治疗6 h后二氧化碳分压(PCO2)及氧分压(PaO2)数值,以及患儿的住院时间、呼吸机治疗费用、鼻部损伤例数等。结果观察组的总有效率为95%,高于对照组的90%,差异无统计学意义(P>0.05);观察组PCO2低于对照组,差异无统计学意义(P>0.05);观察组PaO2及住院时间高于对照组,差异无统计学意义(P>0.05);观察组呼吸机治疗费用低于对照组,差异有统计学意义(P<0.05)。结论高流量鼻导管通气治疗效果与持续呼吸道正压通气相近,但操作更为简便,鼻部损伤发生率低,且治疗费用显著降低,相较于持续呼吸道正压通气优势明显,有效提高基层医院呼吸支持能力。

Objective To investigate the clinical application effect of high-flow nasal cannula ventilation(HFNC)in apnea in premature infants.Methods Forty premature infants who were delivered to the hospital from June 2016 to June 2019 and diagnosed with apnea were selected as randomized groups.Randomized digital table was used to randomize the group into 20 groups in the observation group and the control group.Continuous positive airway pressure(nCPAP)was used and the observation group was treated with high flow nasal cannula.To observe and compare the therapeutic effects of the two treatment methods,as well as the values of partial pressure of carbon dioxide(PCO2)and partial pressure of oxygen(PaO 2)after 6 hours of ventilation therapy in the two groups,as well as the length of hospital stay,ventilator treatment cost,and nasal injury numbers,etc.Results The total effective rate of the observation group was 95%higher than that of the control group,and the difference was not statistically significant(P>0.05);The PCO2 of the observation group was lower than that of the control group,and the difference was not statistically significant(P>0.05);PaO2 and hospitalization time in the observation group were higher than those in the control group,and the difference was not statistically significant(P>0.05);The cost of ventilator treatment in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment effect of high-flow nasal cannula ventilation is close to that of continuous positive airway pressure,but the operation is simpler,the incidence of nasal injury is low,and the treatment cost is significantly reduced.Compared with continuous positive airway pressure,the advantages are obvious,which can effectively improve the respiratory support ability of primary hospital.