摘要
目的探讨经鼻无创高频呼吸机(nHFOV)辅助治疗超低出生体重早产儿呼吸窘迫综合征(NRDS)疗效及对血气分析、脑氧代谢的影响。方法选择超低体质量NRDS早产儿58例作为研究对象,采用随机数字表法将患儿分为nHFOV组和nCPAP组各29例。观察两组在给予辅助通气后的pH、PaCO_(2)、PaO_(3)指标、无创通气时间、治疗失败转为气管插管机械通气等指标,统计两组患儿漏气综合征、脑室出血、脑室周围白质化、BPD和死亡率。结果干预1h后,2组患者PaCO_(2)水平较治疗前显著降低(P<0.05),HCO_(3)、PaO_(3)、BE、pH均较治疗显著升高(P<0.05);干预后2组患者PaCO_(2)、HCO_(3)、PaO_(3)、BE、pH水平相比较,差异均无统计学意义(P>0.05)。nHFOV组无创通气时间和治疗失败转化为插管机械通气率,均显著低于nCPAP组(P<0.05)。nHFOV组患儿脑室出血、脑室周围白质软化、BPD、死亡率均低于nCPAP组,但差异均无统计学意义(P>0.05)。结论与nCPAP相比较,nHFOV作为呼吸支持的主要模式,可减少超低出生体质量NRDS患儿IMV的需求和无创通气时间,值得进一步研究探讨。
Objective To investigate the effect of nasal non-invasive high frequency ventilation(nHFOV) on respiratory distress syndrome(NRDS) of very low birth weight premature infants and its influence on blood gas analysis and cerebral oxygen metabolism.Methods From January 2019 to December 2020, 58 preterm infants with ultra-low body weight NRDS in our hospital were selected as the research objects and randomly divided into the nHFOV group and the nCPAP group, with 29 cases in each group. The indexes of pH, PaCO_(2), PaO_(3), noninvasive ventilation time, conversion from treatment failure to tracheal intubation and mechanical ventilation were observed in the two groups after giving auxiliary ventilation. The air leakage syndrome, intraventricular hemorrhage, periventricular white matter, BPD and mortality of the two groups were statistically analyzed.Results After one hour of intervention, the PaCO_(2)level of the two groups was significantly lower than that before treatment(P<0.05), while HCO_(3), PaO_(3), BE and pH were significantly higher than those before treatment(P<0.05). There was no significant difference in PaCO_(2), HCO_(3), PaO_(3), BE and pH between the two groups after intervention(P>0.05). The time of noninvasive ventilation and the rate of conversion from failure to intubation in the nHFOV group were significantly lower than those in the nCPAP group(P<0.05). The ventricular hemorrhage, periventricular leukomalacia, BPD and mortality in the nHFOV group were lower than those in the nCPAP group, but the difference was not statistically significant(P>0.05).Conclusion Compared with nCPAP, nHFOV as the main mode of respiratory support can reduce the IMV demand and noninvasive ventilation time of NRD children with ultra-low birth weight, which is worthy of further study.
作者
王媛媛
王晔
郄学敏
WANG Yuan-yuan;WANG Ye;QIE Xue-min(Department of Neonatology,Baoding Maternal and Child Health Hospital,Baoding,Hebei 071000,China)
出处
《临床肺科杂志》
2022年第2期184-188,共5页
Journal of Clinical Pulmonary Medicine
基金
保定市科技计划项目(No.2041ZF279)。
关键词
呼吸窘迫综合征
经鼻无创高频呼吸机辅助通气
超低体质量儿
respiratory distress syndrome
nasal noninvasive high frequency ventilator assisted ventilation
ultra low body mass
