无创高频通气在新生儿呼吸暂停治疗中的应用

Application of noninvasive high frequency ventilation in the treatment of neonatal apnea

目的:探讨无创高频通气在新生儿呼吸暂停治疗中的应用效果。方法:回顾性选取张家口市妇幼保健院2019年1月1日至2020年6月1日收治的80例呼吸暂停新生儿为研究对象,按照治疗方法分为A组、B组、C组。A组26例,给予无创高频通气治疗;B组26例,给予双水平持续正压通气治疗;C组28例,给予持续正压通气治疗。治疗10d后,观察比较3组患者临床疗效、呼吸暂停消失时间、发作次数及严重程度评分情况及并发症发生情况。结果:A组总有效率明显高于B组、C组(100.00%vs84.62%vs67.86%),差异有统计学意义(P<0.05);A组患者呼吸暂停消失时间[(18.78±3.24)h]明显短于B组[(22.52±4.28)h]、C组[(25.53±5.39)h],呼吸暂停发作次数[(3.34±0.75)次]明显少于B组[(4.93±1.06)次]、C组[(6.62±1.33)次],严重程度评分[(0.68±0.14)分]明显低于B组[(1.23±0.26)分]、C组[(1.72±0.38)分],差异均有统计学意义(均P<0.05);A组患者脑白质软化、早产视网膜病变、颅内出血及慢性肺病的发生率(0.00%、3.85%、0.00%、7.69%)均明显低于B组(15.38%、23.08%、15.38%、30.77%),C组(25.00%、32.14%、30.77%、35.71%),差异均有统计学意义(均P<0.05)。结论:无创高频通气治疗呼吸暂停新生儿临床疗效显著,可促进患者恢复,改善预后,安全性良好,值得临床推广应用。

Objective:To explore the application effect of noninvasive high frequency ventilation in the treatment of neonatal apnea.Methods:A total of 80 cases of neonates with apnea admitted to Zhangjiakou Maternal and Child Health Hospital from January 1,2019 to June 1,2020 were retrospectively selected as the research objects and divided into group A,group B,group C according to the treatment method.Twenty-six patients in group A were treated with noninvasive high-frequency ventilation.Twenty-six patients in group B were treated with two-level continuous positive pressure ventilation.Twenty-eight patients in group C were treated with continuous positive pressure ventilation.After 10 days of treatment,the clinical efficacy,disappearance time of apnea,frequency of attack,severity score and incidence of complications in 3 groups were observed and compared.Results:The total effective rate of group A was significantly higher than that of group B and group C(100.00%,84.62%,67.86%),the difference was statistically significant(P<0.05);the disappearance time of apnea in group A[(18.78±3.24)h]was significantly shorter than that in group B[(22.52±4.28)h],and group C[(25.53±5.39)h],and the number of apnea episodes[(3.34±0.75)times]was significantly less than that in group B[(4.93±1.06)times]and group C[(6.62±1.33)times],and the severity score[(0.68±0.14)points]was significantly lower than that in group B[(1.23±0.26)points]and group C[(1.72±0.38)points],and the difference was statistically significant(P<0.05);the incidences of leukomalacia,retinopathy of prematurity,intracranial hemorrhage and chronic lung disease in group A(0.00%,3.85%,0.00%,7.69%)were significantly lower than those in group B(15.38%,23.08%,15.38%,30.77%),and group C(25.00%,32.14%,30.77%,35.71%),and the difference was statistically significant(P<0.05).Conclusion:The clinical effect of noninvasive high frequency ventilation in the treatment of neonatal apnea is significant,which can promote the recovery of patients,improve the prognosis,and has good safety,and noninvasive high frequency ventilation is worthy of clinical application.