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目的探讨加温湿化经鼻导管高流量通气对超低出生体重早产儿拔管失败的预防效果。方法选取2013年1月至2015年5月收治的60例预拔除气管插管改为无创辅助呼吸的超低出生体重早产儿,采用随机数表法将患儿分为观察组与对照组,每组30例。对照组采用经鼻持续气道正压通气(NCPAP),观察组采用加温湿化经鼻导管高流量通气(HHHFNC),比较两组有创通气时间、无创通气时间、总用氧时间、以及拔管失败等并发症发生率。结果观察组有创通气时间、总用氧时间分别为(6.53±3.02)d、(19.17±5.51)d,与对照组比较显著较低(P<0.05),两组无创通气时间比较无统计学意义(P>0.05);两组拔管失败率比较无统计学意义(P>0.05),观察组鼻部损伤、气漏、喂养不耐受、腹胀等并发症发生率分别为6.67%、10.00%、6.67%、6.67%,与对照组比较均显著较低(P<0.05)。结论加温湿化经鼻导管高流量通气可明显缩短超低出生体重早产儿有创通气时间,减少用氧,并能有效预防拔管失败等并发症,值得在临床应用。
Objective To investigate the preventive effect of warming and humid nasal catheter hyperbaric ventilation on extubation of ultra-low birth weight preterm infants. Methods From January 2013 to May 2015, 60 cases of preterm infants with preterm and extrabronchial endotracheal intubation replaced by non-invasive assisted breathing of low birth weight preterm infants were divided into observation group and control group by random number table method Group of 30 cases. In the control group, nasal continuous positive airway pressure (NCPAP) was used. In the observation group, warm-humidified nasal catheter hyperventilation (HHHFNC) was used. The duration of invasive ventilation, non-invasive ventilation, Extubation failure and other complications. Results The duration of invasive ventilation in the observation group was (6.53 ± 3.02) d and (19.17 ± 5.51) days, respectively, which was significantly lower than that in the control group (P <0.05). There was no significant difference in the duration of non-invasive ventilation between the two groups (P> 0.05). There was no significant difference in extubation failure rate between the two groups (P> 0.05). The complication rates of nasal injury, air leakage, feeding intolerance and bloating in observation group were 6.67%, 10.00 %, 6.67% and 6.67% respectively, which were significantly lower than those in the control group (P <0.05). Conclusions Warming and humid nasal cannulation with high flow ventilation can shorten the duration of invasive ventilation and reduce the use of oxygen in ultra-low birth weight preterm infants, and can effectively prevent the complications such as failure of extubation, which is worthy of clinical application.