两种辅助通气方式治疗极低出生体重儿呼吸窘迫综合征临床疗效分析

Comparison of clinical efficacy of heated humidified high flow nasal cannula versus nasal continuous positive airway pressure in treatment of respiratory distress syndrome in very low birth weight infants

摘要:

目的 比较加温湿化经鼻导管高流量通气(HHHFNC)和鼻塞式持续气道正压通气(NCPAP)应用于极低出生体重儿呼吸窘迫综合征的临床疗效。方法 选择呼吸窘迫综合征(RDS)的极低出生体重患儿66例,接受猪肺表面活性物质及相关常规治疗后随机分为HHHFNC组和NCPAP组,观察两组患儿临床症状改善情况及其各种并发症的发生率。结果 与NCPAP组相比,HHHFN组患儿开奶时间及达到全肠道喂养时间明显提前,氧暴露时间和有创通气时间降低,7 d内重新插管、鼻部损伤、气漏、腹胀的发生率降低。结论 与NCPAP组相比,HHHFNC有相关损伤更小、耐受性更好的特点,是可以首选的一种治疗极低出生体重儿RDS的无创通气模式。

Abstract:

Objective To compare the differences of clinical efficacy between heated humidified high-flow nasal cannula (HHHFNC) ventilation and nasal continuous positive airway pressure (NCPAP) in the treatment of respiratory distress syndrome (RDS) in very low birth weight (VLBW) infants. Methods A total of 66 VLBW infants who were admitted to the neonatal intensive care unit were diagnosed with RDS, and they were randomly assigned to HHHFNC group and NCPAP group after receiving treatment with porcine pulmonary surfactant and conventional treatment. The changes in clinical symptoms and the incidence of complications were observed in the two groups. Results The HHHFN group had significantly earlier first milk feeding and full enteral feeding, significantly shorter oxygen exposure time and invasive ventilation time, and significantly lower incidences of second intubation within 7 days, nasal injury, air leak, and abdominal distention, as compared with the NCPAP group. Conclusions Compared with NCPAP, HHHFNC causes slighter injury and has better tolerability, and it can be considered as the first choice of noninvasive ventilation in the treatment of RDS in VLBW infants.