加温加湿高流量经鼻正压通气在新生儿呼吸窘迫综合征中的应用价值

Application value of heating and humidifying high flow positive nasal pressure ventilation in neonatal respiratory distress syndrome

目的探讨加温加湿高流量经鼻正压通气在新生儿呼吸窘迫综合征中的应用价值。方法选取2019年6月至2020年12月本院收治的68例呼吸窘迫综合征患儿作为研究对象,采取随机数字表法分为对照组和观察组,各34例。对照组给予鼻塞式持续气道正压通气,观察组给予加温加湿高流量经鼻导管正压通气。比较两组临床指标、血气指标及并发症发生情况。结果两组无创通气时间比较差异无统计学意义;观察组呼吸暂停次数少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。治疗前,两组动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、氧合指数(OI)比较差异无统计学意义;治疗后24、48 h,两组PaCO_(2)低于治疗前,PaO_(2)、OI均高于治疗前,且观察组PaCO_(2)低于对照组,PaO_(2)、OI均高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(5.88%)明显低于对照组(23.53%),差异有统计学意义(P<0.05)。结论加温加湿高流量经鼻正压通气应用于新生儿呼吸窘迫综合征中,可减少呼吸暂停次数,缩短住院时间,改善血气指标,降低并发症发生率,具有较高的应用价值。

Objective To explore the application value of heating and humidifying high flow transnasal positive pressure ventilation in neonatal respiratory distress syndrome.Methods A total of 68 cases of neonatal respiratory distress syndrome treated in our hospital from June 2019 to December 2020 were selected as the research subjects,they were divided into control group and observation group according to the random number table method,with 34 cases in each group.The control group was given nasal continuous positive airway pressure ventilation,and the observation group was given heating and humidification high flow nasal catheter positive airway pressure ventilation.The clinical indexes,blood gas indexes and complications were compared between the two groups.Results There was no significant difference in noninvasive ventilation time between the two groups;The number of apnea in the observation group was less than that in the control group,and the hospitalization time was shorter than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2))and oxygenation index(OI)between the two groups;24 and 48 hours after treatment,PaCO_(2)in the two groups was lower than that before treatment,PaO_(2)and OI were higher than those before treatment,and PaCO_(2)in the observation group was lower than that in the control group,PaO_(2)and OI were higher than those in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group(5.88%)was significantly lower than that in the control group(23.53%),and the difference was statistically significant(P<0.05).Conclusion The application of heating and humidifying high flow positive transnasal pressure ventilation in neonatal respiratory distress syndrome can reduce the number of apnea,shorten the length of hospital stay,improve blood gas indexes and reduce the incidence of complications,which has high application value.