经鼻无创高频呼吸机对ELBW早产儿的疗效分析

Efficacy analysis of transnasal non-invasive high-frequency ventilator on premature infants with ELBW

目的 探讨经鼻无创高频呼吸机辅助治疗超低出生体重(ELBW)早产儿呼吸窘迫综合征(RDS)的疗效及对血气分析和脑氧代谢的影响。方法 选取2017年3月至2021年3月于沧州市妇幼保健院接受治疗的201例发生RDS的ELBW早产儿为研究对象,通过抽签法随机将患儿分为观察组(101例)和对照组(100例),两组患儿均给予常规治疗,在其基础上,对照组采用经鼻持续正压通气,观察组采用经鼻无创高频呼吸机辅助通气,比较两组患儿治疗后的临床疗效、血气分析结果[二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))]、血氧饱和度(SpO_(2))、脑氧代谢相关指标[脑氧饱和度(rSO_(2))、颈静脉血氧饱和度(SjVO_(2))、平均动脉压(MABP)]、并发症发生情况及临床相关指标。结果 治疗后,观察组总有效率(92.08%)显著高于对照组(80.00%),差异有统计学意义(χ^(2)=6.115,P<0.05);观察组患儿血气分析指标PaCO_(2)水平显著低于对照组(t=5.952,P<0.05),PaO_(2)和SpO_(2)水平显著高于对照组(t值分别为6.824、3.347,P<0.05);观察组患儿脑氧代谢指标rSO_(2)、SjVO_(2)和MABP水平均显著高于对照组(t值分别为10.033、7.486、6.338,P<0.05)。治疗期间,观察组患儿并发症总发生率(10.89%)显著低于对照组(28.00%),差异有统计学意义(χ^(2)=9.406,P<0.05)。观察组患儿呼吸机使用总时间和住院时间均显著短于对照组,差异均有统计学意义(t值分别为5.307、7.739,P<0.05)。结论 经鼻无创高频呼吸机辅助治疗ELBW早产儿RDS的疗效显著,可有效地改善患儿的通气和脑氧代谢水平,减少相关并发症的发生,促进患儿康复,值得临床高度重视和推广使用。

Objective To explore the efficacy of transnasal non-invasive high-frequency ventilator in the treatment of premature infants with extremely low birth weight(ELBW) and respiratory distress syndrome(RDS),and its influence on blood gas analysis and cerebral oxygen metabolism.Methods 201 ELBW premature infants with RDS who were treated in Cangzhou Women and Children′s Healthcare Hospital from March 2017 to March 2021 were selected as the research subjects, and they were randomly divided into the observation group(101 cases) and the control group(100 cases) by the lottery method.Both groups of children were given conventional treatment, and on the basis of which, the control group was treated with transnasal continuous positive pressure ventilation, and the observation group was treated with transnasal non-invasive high-frequency ventilator.The clinical efficacy, blood gas analysis results [partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2))],blood oxygen saturation(SpO_(2)),cerebral oxygen metabolism-related indicators [cerebral regional oxygen saturation(rSO_(2)),jugular venous blood oxygen saturation(SjVO_(2)),mean arterial blood pressure(MABP)],occurrence of complications and clinical related indicators were compared between the two groups after treatment.Results After treatment, the total effective rate of the observation group(92.08%) was higher than that of the control group(80.00%),and the difference was statistically significant(χ^(2)=6.115,P<0.05).The blood gas index PaCO_(2) level of the observation group was significantly lower than that of the control group(t=5.952,P<0.05).The PaO_(2) and SpO_(2) levels were significantly higher than those of the control group(t=6.824 and 3.347,respectively, P<0.05).The cerebral oxygen metabolism indexes rSO_(2),SjVO_(2) and MABP levels in the observation group were higher than those of the control group(t=10.033,7.486 and 6.338,respectively, P<0.05).During the treatment period, the total incidence of complications in the observation group(10.89%) was lower than that in the control group(28.00%),and the difference was statistically significant(χ^(2)=9.406,P<0.05).The total time of ventilator use and hospital stay of infants in the observation group were shorter than those in the control group, and the difference was significant(t=5.307 and 7.739,respectively, P<0.05).Conclusion Transnasal non-invasive high-frequency ventilator has a significant efficacy in the treatment of RDS in premature ELBW infants.And it can effectively improve the ventilation and cerebral oxygen metabolism, reduce the occurrence of related complications, and promote the rehabilitation of infants.It is worthy of clinical attention and promotion.