经鼻无创高频振荡通气和持续气道正压通气在早产儿呼吸窘迫综合征撤机后的应用比较

发布时间：2018-05-10 16:35

  本文选题：新生儿呼吸窘迫综合征 + 经鼻无创高频振荡通气　； 参考：《广东医学》2017年13期

【摘要】：目的探讨患有重度新生儿呼吸窘迫综合征(NRDS)的早产儿撤机后使用经鼻无创高频振荡通气(NHFOV)和经鼻持续气道正压通气(NCPAP)的效果,以确定NHFOV是否可提高撤机成功率。方法选择入住新生儿重症监护病房、胎龄28~35周、需要有创呼吸支持并且在生后3周内撤机的重度NRDS早产儿,共入选65例,撤机后随机分为NHFOV组(34例)和NCPAP组(31例),若应用这两种方式不能维持则需再次气管插管机械通气。主要观察指标为撤机成功率、失败原因分析以及使用无创呼吸支持后1、12、24、48、72 h血气中氧分压(PaO_2)、二氧化碳分压(PaCO_2)、PaO_2/氧浓度(FiO_2)。结果 NHFOV组撤机成功率为85.29%,高于NCPAP组的61.29%(P0.05)。两组总用氧时间、气胸、支气管肺发育不良、坏死性小肠结肠炎和颅内出血发生率(Ⅲ度及以上)差异无统计学意义(P0.05)。结论对于撤机后的早产儿,使用NHFOV比NCPAP有更高的成功率。
[Abstract]:Objective to investigate the effect of NHFOV in the treatment of premature infants with severe neonatal respiratory distress syndrome (NRDS) by using noninvasive high frequency oscillatory ventilation (NHFOV) and continuous positive airway pressure ventilation (CPAP) after weaning, so as to determine whether NHFOV can improve the success rate of weaning. Methods 65 cases of severe NRDS premature infants who were admitted to neonatal intensive care unit (NICU) and whose gestational age was 28 ~ 35 weeks and needed invasive respiratory support and were weaned within 3 weeks after birth were selected. After weaning, the patients were randomly divided into NHFOV group (n = 34) and NCPAP group (n = 31). The main outcome measures were success rate of weaning, cause analysis of failure, and PaO2 partial pressure in blood gas (Pao _ 2 / Pao _ 2 / O _ 2 / O _ 2 / O _ 2 / P _ 2O _ 2 / P _ 2O _ 2) after non-invasive respiratory support for 1 h, Pao _ 2 and PaCO _ 2 / P _ O _ 2 / P _ O _ 2 / P _ 2O _ 2 / P _ 2O _ 2 / P _ 2O _ 2. Results the success rate of weaning in NHFOV group was 85.29%, higher than that in NCPAP group (61.29%). There was no significant difference in total oxygen use time, pneumothorax, bronchopulmonary dysplasia, necrotizing enterocolitis and intracranial hemorrhage (鈪，

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