HHHFNC治疗新生儿MAS合并Ⅰ型呼吸衰竭的有效性及安全性

Efficacy and safety of HHHFNC in the treatment of neonatal MAS with typeⅠrespiratory failure

目的浅析新生儿胎粪吸入综合征(MAS)合并Ⅰ型呼吸衰竭进行加温湿化高流量鼻导管通气(HHHFNC)治疗的有效性及安全性。方法128例MAS合并Ⅰ型呼吸衰竭新生儿,以系统抽样法作为原则分为对照组和研究组,每组64例。对照组新生儿给予经鼻持续气道正压通气(NCPAP)治疗,研究组新生儿给予HHHFNC治疗。比较两组新生儿治疗前后血气分析指标[动脉血二氧化碳分压(PaCO_(2))、氧分压(PaO_(2))、酸碱度(pH)值],并发症发生情况,气喘缓解时间及住院时间。结果治疗12、24 h,两组的pH值均高于治疗前,差异具有统计学意义(P<0.05)。治疗12、24 h,两组的PaCO_(2)均低于治疗前,且研究组治疗24 h的PaCO_(2)低于对照组,差异具有统计学意义(P<0.05)。治疗12、24 h,两组的PaO_(2)高于治疗前,且研究组的PaO_(2)高于对照组,差异具有统计学意义(P<0.05)。研究组新生儿并发症发生率为4.69%,显著低于对照组的15.63%,差异具有统计学意义(P<0.05)。研究组新生儿气喘缓解时间为(3.25±0.48)d,住院时间为(6.75±1.12)d,均短于对照组的(4.57±0.46)、(7.78±1.33)d,差异具有统计学意义(P<0.05)。结论HHHFNC治疗新生儿MAS合并Ⅰ型呼吸衰竭有着较高的有效性和安全性,值得深入推广应用。

Objective To analylze the efficacy and safety of heated humidified high flow nasal cannula(HHHFNC)in the treatment of neonatal meconium aspiration syndrome(MAS)with typeⅠrespiratory failure.Methods A total of 128 cases of MAS with typeⅠrespiratory failure were divided into control group and research group according to systematic sampling method,with 64 cases in each group.The control group was treated with nasal continuous positive airway pressure(NCPAP),and the research group was treated with HHHFNC.The blood gas analysis indexes[arterial partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),pH value]before and after treatment,occurrence of complications,asthma remission time and hospitalization time were compared between the two groups.Results After 12 and 24 h of treatment,the pH value of the two groups were higher than those before treatment,and the difference was statistically significant(P<0.05).After 12 and 24 h of treatment,the PaCO_(2) of the two groups were lower than those before treatment,and the PaCO_(2) after 24 h of treatment of the research group was lower than that of the control group.All the difference was statistically significant(P<0.05).After 12 and 24 h of treatment,the PaCO_(2) of the two groups was higher than that before treatment,and the PaCO_(2) of the research group was higher than that of the control group.All the difference was statistically significant(P<0.05).The incidence of complications of the research group was 4.69%,which was significantly lower than 15.63%of the control group,and the difference was statistically significant(P<0.05).The asthma remission time(3.25±0.48)d and hospitalization time(6.75±1.12)d of the research group were shorter than(4.57±0.46)and(7.78±1.33)d of the control group,and the difference was statistically significant(P<0.05).Conclusion HHHFNC has high efficacy and safety on the treatment of neonatal MAS and typeⅠrespiratory failure,and it is worthy of further popularization and application.