两种不同通气方式联合枸橼酸咖啡因治疗新生儿呼吸窘迫综合征的疗效观察

Observation on the Efficacy of Two Different Ventilation Methods Combined with Caffeine Citrate in the Treatment of Neonatal Respiratory Distress Syndrome

目的:观察两种不同通气方式联合枸橼酸咖啡因治疗新生儿呼吸窘迫综合征(NRDS)的疗效。方法:选择2021年4月—2022年12月于我院治疗的78例NRDS患儿,按随机数字表法分为经鼻持续气道正压通气(NCPAP)组与高流量鼻导管吸氧(HHFNC)组,各39例。两组均采用枸橼酸咖啡因治疗,NCPAP组采用NCPAP治疗,HHFNC组采用HHFNC治疗。比较两组血气指标、通气、住院情况及并发症。结果:两组治疗后的pH、动脉血氧分压(PaO_(2))均高于治疗前,动脉血二氧化碳分压(PaCO_(2))及吸入氧浓度(FiO_(2))均低于治疗前,有统计学差异(P<0.05);HHFNC组开奶时间为(63.86±11.07)h,短于NCPAP组的(76.59±14.13)h,HHFNC组的鼻损伤(7.69%)、腹胀发生率(5.13%)均低于NCPAP组(25.64%、20.51%),有统计学差异(P<0.05);两组治疗后的pH、PaO_(2)、PaCO_(2)、FiO_(2)、通气时间、氧疗时间、住院时间及其他并发症发生率比较,无统计学差异(P>0.05)。结论:HHFNC联合枸橼酸咖啡因治疗NRDS能够改善患儿低氧血症、氧合功能,缩短开奶时间,且腹胀和鼻损伤发生率低,临床应用安全可靠。

Objective:To observe the efficacy of two different ventilation methods combined with caffeine citrate in the treatment of neonatal respiratory distress syndrome(NRDS).Method:78 children with NRDS who were treated in our hospital from April 2021 to December 2022 were randomly divided into a nasal continuous positive airway pressure ventilation(NCPAP)group and a high flow nasal catheter oxygen inhalation(HHFNC)group using a random number table method,with 39 cases in each group.Both groups were treated with caffeine citrate,the NCPAP group was treated with NCPAP,and the HHFNC group was treated with HHFNC.Compare the blood gas indicators,ventilation,hospitalization status,and complications between the two groups.Results:After treatment,the pH and PaO_(2) of the two groups were higher than those before treatment,and the PaCO_(2) and FiO_(2) of arterial blood were lower than those before treatment,with statistical difference(P<0.05);The lactation time in the HHFNC group was(63.86±11.07)hours,which was shorter than that in the NCPAP group(76.59±14.13)hours.The incidence of nasal injury(7.69%)and abdominal distension(5.13%)in the HHFNC group was lower than that in the NCPAP group(25.64%,20.51%),with statistical differences(P<0.05);There was no statistically significant difference(P>0.05)between the two groups in terms of pH,PaO_(2),PaCO_(2),FiO_(2),ventilation time,oxygen therapy time,hospitalization time,and other complications after treatment.Conclusion:HHFNC combined with caffeine citrate can improve the hypoxemia and oxygenation function of children with NRDS,shorten the milk opening time,and reduce the incidence of abdominal distention and nasal injury.It is safe and reliable for clinical application.