经鼻高流量湿化氧疗与持续气道正压通气治疗新生儿肺炎的对比分析

Comparative analysis of nasal high-flow humidification oxygen therapy and continuous positive airway pressure in the treatment of neonatal pneumonia

目的研究经鼻高流量湿化氧疗与持续气道正压通气对新生儿肺炎血气指标与炎性因子的影响。方法选取中信惠州医院2018年1月至2021年1月收治的58例新生儿肺炎患儿,按照随机数字表法分为对照组(29例)与治疗组(29例)。对照组患儿进行经鼻持续气道正压通气治疗,治疗组患儿进行经鼻高流量湿化氧疗,血气分析指标基本正常时稳定12~24 h后改为鼻导管吸氧,并于治疗后持续观察7 d。比较两组患儿治疗前与治疗后24 h的临床症状改善情况、血气指标及炎性因子水平,治疗后并发症发生情况。结果与治疗前比,治疗后24 h两组患儿心率(HR)、呼吸频率(RR)、动脉血二氧化碳分压(PaCO_(2))及血清白介素-6(IL-6)、C-反应蛋白(CRP)、降钙素原(PCT)水平均显著降低,且治疗组显著低于对照组;治疗后24 h两组患儿动脉血氧分压(PaO2)、动脉/肺泡氧分压(a/APO2)及治疗组患儿新生儿危重病例评分均显著升高,且治疗组显著高于对照组;治疗组患儿的并发症总发生率显著低于对照组(均P<0.05)。结论经鼻高流量湿化氧疗能有效改善肺炎患儿机体血气水平,同时可抑制血清炎性因子的释放,降低并发症发生率。

Objective To study the effects of nasal high-flow humidification oxygen therapy and continuous positive airway pressure on blood gas indicators and inflammatory factors of neonates with pneumonia.Methods A total of 58 children with neonatal pneumonia admitted to CITIC Huizhou Hospital from January 2018 to January 2021 were selected and divided into the control group(29 cases)and the treatment group(29 cases)according to the random number table method.Children in the control group were treated with continuous positive airway pressure through the nose,and children in the treatment group were treated with nasal high-flow humidification oxygen therapy,when the blood gas analysis was basically normal,they were stable for 12 to 24 hours and then changed to nasal catheter oxygen inhalation,and continued to observe for 7 d after treatment.The clinical symptoms improvement,blood gas indexes and inflammatory factor levels before and 24 h after treatment,and the occurrence of complications after treatment of children were compared between the two groups.Results Compared with before treatment,the heart rate(HR),respiratory rate(RR),arterial partial pressure of carbon dioxide(PaCO_(2)),serum interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)levels reduced significantly,and the treatment group was significantly lower than the control group;24 h after treatment,arterial blood oxygen partial pressure(PaO2),arterial/alveolar oxygen partial pressure(a/APO2)and the neonatal critical case score of the treatment group increased significantly,and the treatment group was significantly higher than the control group;the total incidence of complications in the treatment group was significantly lower than that of the control group(all P<0.05).Conclusion Nasal high-flow humidification oxygen therapy can effectively improve the blood gas level of the children with neonatal pneumonia,while neonatal inhibiting the release of serum inflammatory factors and reducing the incidence of complications.