无创高频振荡通气与经鼻间歇正压通气治疗新生儿呼吸窘迫综合征的临床研究

Clinical Study of Noninvasive High Frequency Oscillatory Ventilation and Nasal Intermittent Positive Pressure Ventilation in the Treatment of Neonatal Respiratory Distress Syndrome

目的:探究无创高频振荡通气(nHFOV)与经鼻间歇正压通气(NIPPV)治疗新生儿呼吸窘迫综合征(NRDS)的临床价值。方法:选取2019年8月-2021年2月惠州市第三人民医院收治的NRDS患儿60例。简单随机分为对照组(n=30)和观察组(n=30)。对照组给予NIPPV治疗,观察组给予nHFOV治疗。比较两组患儿治疗前后的动脉血气指标、机械通气时间、总用氧时间、全量喂养时间、住院时间及并发症。结果:治疗后,两组患儿的PaO_(2)/FiO_(2)、PaO_(2)均明显升高,PaCO_(2)均明显下降,且观察组PaCO_(2)明显低于对照组(P<0.05)。治疗后,与对照组相比,观察组的机械通气时间、总用氧时间、全量喂养时间、住院时间均明显更短,观察组高碳酸血症发生率明显更低(P<0.05);两组呼吸暂停、支气管肺发育不良、低氧血症、溶血发生率比较差异均无统计学意义(P>0.05)。结论:nHFOV与NIPPV均可有效改善NRDS,提高患儿的肺氧合能力,但nHFOV降低PaCO_(2)效果更好,在改善通气功能及减少高碳酸血症发生方面更具优势。

Objective:To explore the clinical value of noninvasive high frequency oscillatory ventilation(nHFOV)and nasal intermittent positive pressure ventilation(NIPPV)in the treatment of neonatal respiratory distress syndrome(NRDS).Method:A total of 60 cases of NRDS in Third People’s Hospital of Huizhou City from August 2019 to February 2021 were selected and simply randomly divided into the control group(n=30)and observation group(n=30).The control group was given the NIPPV treatment,and the observation group was given the nHFOV treatment.The arterial blood gas index before and after treatment,mechanical ventilation time,total oxygen consumption time,full feeding time,hospitalization time and complications were compared between the two groups.Result:After treatment,PaO_(2)/FiO_(2)and PaO_(2)of the two groups were significantly increased,PaCO_(2)of the two groups were significantly decreased,and PaCO_(2)of the observation group was significantly lower than that of the control group(P<0.05).After treatment,compared with the control group,the mechanical ventilation time,total oxygen consumption time,full feeding time and hospitalization time in the observation group were significantly shorter,and the incidence of hypercapnia in the observation group was significantly lower(P<0.05).There were no significant differences in the incidence of apnea,bronchopulmonary dysplasia,hypoxemia,hemolysis between the two groups(P>0.05).Conclusion:Both nHFOV and NIPPV can effectively improve NRDS and improve pulmonary oxygenation capacity of children,but nHFOV has better effect in reducing PaCO_(2),and has more advantages in improving ventilation function and reducing the occurrence of hypercapnia.