呼吸机无创高频振荡通气在极低出生体质量儿呼吸窘迫综合征42例中的疗效分析

Efficacy analysis of non-invasive high frequency oscillatory ventilation with ventilator in 42 cases of very low birth weight infants with respiratory distress syndrome

目的探讨无创高频振荡通气在极低出生体质量儿呼吸窘迫综合征拔管撤机后的效果。方法选择2017年3月至2019年2月在四川省妇幼保健院接受有创呼吸支持超48 h,并在出生3周内撤机的极低出生体质量呼吸窘迫综合征病儿85例进行回顾性分析。根据接受呼吸支持的不同将其分为两组,对照组43例行经鼻持续气道正压通气(NCPAP),观察组42例行经鼻无创高频振荡通气模式(NHFOV)。对比两组7 d内撤机成功率、血气分析指标、一般情况、并发症发生情况。结果观察组7 d内撤机成功率为83.72%,明显高于对照组的65.12%(P<0.05)。两组二氧化碳分压(PaCO_(2))水平均明显下降,但观察组下降幅度更大,两组氧分压(PaO_(2))及氧分压/吸氧分数(FiO_(2))水平均明显升高,但观察组升高更明显(P<0.05)。两组总辅助通气时间对比差异无统计学意义(P>0.05),但观察组开奶时间及全肠喂养时间均明显较对照组短(P<0.05)。对照组共出现14例(33.33%)并发症,与观察组出现5例(11.63%)对比差异有统计学意义(P<0.05)。结论NHFOV较NCPAP可明显提高极低出生体质量儿呼吸窘迫综合征拔管撤机成功率,改善病儿血气分析指标,缩短开奶时间及全肠喂养时间,降低并发症发生率。

Objective To investigate the effect of non-invasive high frequency oscillatory ventilation(NHFOSV)on very low birth weight infants with respiratory distress syndrome after extubation.Methods A retrospective analysis of 85 children with very low birth weight respiratory distress syndrome who underwent invasive respiratory support for 48 hours and withdrawn within 3 weeks of birth in Sichuan Maternal and Child Health Hospital from March 2017 to February 2019 was performed.According to the children's respiratory support,they were divided into two groups.The control group underwent nasal continuous positive airway pressure(NCPAP),and the observation group underwent NHFOV.The success rate of 7d weaning,blood gas analysis index,general condition and complications were compared between the two groups.Results The success rate of 7d weaning in the observation group was 83.72%,which was significantly higher than that in the control group(65.12%)(P<0.05).The Partial Pressure of Carbon Dioxide(PaCO2)levels in the two groups were significantly decreased,but the decrease was greater in the observation group.The Partial Pressure Of Oxygen(PaO2)and PaO2/FiO2 levels were significantly increased in the two groups,but the increase in the observation group was more significant(P<0.05).There was no significant difference in the total assisted ventilation time between the two groups(P>0.05),but the observation time and the total feeding time were significantly shorter in the observation group than in the control group(P<0.05).There were 14 cases(33.33%)of complications in the control group,and the difference was statistically significant in 5 cases(11.63%)in the observation group(P<0.05).Conclusion NHFOV can significantly improve the success rate of extubation and weaning of very low birth weight infants with respiratory distress syndrome,improve the blood gas analysis index,shorten the time of opening milk and whole intestine feeding,and reduce the incidence of complications compared with NCPAP.