经鼻高流量氧疗在新生儿无创通气中的应用效果

Application of transnasal high flow oxygen therapy in noninvasive ventilation of newborn

目的探讨经鼻高流量氧疗(HFNC)在新生儿无创通气中的应用效果。方法选取2015年2月~2018年12月我院收治的76例机械通气新生儿为研究对象,采用随机数字表法分为对照组和观察组,每组各38例。对照组进行经鼻持续气道正压通气(NCPAP),观察组进行HFNC。比较两组通气前后血气分析指标[pH值、血二氧化碳分压(PaCO2)和血氧分压(PaO2)],临床症状消失时间及撤机并发症发生率。结果通气前和通气24、72 h后两组的pH值、PaCO2和PaO2比较,差异无统计学意义(P>0.05);观察组新生儿的气促、肺部啰音、三凹征、发绀症状消失时间短于对照组,差异有统计学意义(P<0.05);观察组撤机并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论HFNC应用于新生儿无创通气效果与NCPAP相当,但HFNC有利于临床症状改善和减少并发症,整体通气效果优于NCPAP。

Objective To discuss the effect of transnasal high flow oxygen therapy(HFNC)in noninvasive ventilation of newborn.Methods A total of 76 neonates with mechanical ventilation admitted to our hospital from February,2015 to December 2018 were selected as subjects and divided into observation group and control group according to random number table method,38 cases in each group.Neonates in control group were given nasal continuous positive airway pressure(NCPAP),and neonates in observation group were given HFNC.The indexes of blood gas analysis(pH,partial pressure of blood carbon dioxide[PaCO2]and oxygen[PaO2]),disappearance time of clinical symptoms and complications between two groups were compared.Results There were no significant differences in pH,PaCO2 and PaO2 between the two groups before ventilation,24 and 72 hours after ventilation(P>0.05).The disappearance time of dyspnea,lung rales,three concave sign and cyanosis in observation group were shorter than those in control group,the differences were significant(P<0.05).The incidence of complications in observation group was lower than that in control group,the difference was significant significant(P<0.05).Conclusion The effect of HFNC on neonatal noninvasive ventilation is similar to that of NCPAP,but HFNC can improve clinical symptoms and reduce complications,and the overall ventilation effect is better than that of NCPAP.