湿化、高流量双鼻导管吸氧与nCPAP治疗早产儿呼吸暂停的疗效比较

目的对比湿化、高流量双鼻导管吸氧(HHFNC)与鼻塞持续气道正压通气(nCPAP)治疗早产儿呼吸暂停的疗效。方法 2009年1月～2010年6月在本院新生儿科诊断为呼吸暂停的早产儿共65例,随机分为HH-FNC组和nCPAP组。HHFNC组在药物治疗基础上采用湿化、高流量双鼻导管吸氧,nCPAP组在药物治疗基础上采用鼻塞CPAP通气支持。结果 nCPAP组显效率及总有效率明显高于HHFNC组,差异有统计学意义(P<0.05)。两组因病情加重需改用气管插管机械通气支持的例数比较差异无统计学意义(P>0.05)。HHFNC组中出现鼻黏膜出血较nCPAP组显著增多,差异有统计学意义(P<0.01)。nCPAP组中出现皮肤损伤较HHFNC组显著增多,差异有统计学意义(P<0.01)。两组腹胀与呼吸道感染发生率比较差异无统计学意义(P>0.05)。结论 nCPAP在治疗早产儿呼吸暂停中较湿化、高流量双鼻导管吸氧更有效,但需注意皮肤损伤的问题。

Comparison of the effect of humidified high flow nasal cannula therapy(HHFNC)and nasal continuous positive airway pressure(nCPAP)on neonatal apnea

Objective To compare the effect of humidified high flow nasal cannula therapy(HHFNC) and nasal continuous positive airway pressure(nCPAP) in treating neonatal apnea.Methods 65 preterm infants diagnosed with neonatal apnea in our hospital from January 2009 to June 2010 were randomly divided into the HHFNC group and the nCPAP group.The HHFNC group were treated with humidified high-flow nasal cannula therapy on the basis of drug therapy and the nCPAP group were treated by CPAP aerating the congested nose on the basis of drug therapy.Results The particular effective rate and total effective rate of the nCPAP group were obviously higher than those of the HHFNC group,which were significantly different(P<0.05).There was no significant difference in cases of endotracheal intubation to invasive mechanical ventilation between the 2 groups(P>0.05).Cases of bleeding in the nose mucous membrane in the HHFNC group were obviously more than those in the nCPAP group,which were significantly different(P<0.01).Cases of skin damage in the nCPAP group were obviously more than those in the HHFNC group,which were also significantly different(P<0.01).There was no significant difference in cases of abdominal distension and the respiratory infection between the 2 groups(P>0.05).Conclusion nCPAP is more effective in treating neonatal apnea than HHFNC.But the problem of skin damage should be concerned.