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目的:探讨湿化高流量鼻导管通气预防超低出生体质量儿拔管失败的临床效果。方法:收集2015年1月至2016年7月梅州市人民医院新生儿重症监护病房收治的超低出生体质量儿36例的病历资料,患儿生后均经气管插管接呼吸机辅助呼吸,撤机拔管后按随机数字表法分为两组,对照组16例,采取鼻塞式持续气道正压通气治疗(NCPAP),观察组20例,采取湿化高流量经鼻导管通气治疗(HHFNC),观察并比较两组患儿治疗7 d内拔管失败率、并发症发生率及通气治疗时间。结果:两组患儿治疗7 d内拔管失败率、通气治疗时间及肺气漏、支气管肺发育不良发生率比较,无统计学差异(P>0.05),观察组鼻损伤、腹胀发生率明显低于对照组(P<0.01)。结论:湿化高流量鼻导管通气能有效预防超低出生体质量儿拔管失败,同时降低鼻损伤、腹胀发生率,提高患儿舒适感。
Objective: To investigate the clinical effect of humidified high-flow nasal catheter ventilation on preventing extubation of ultra-low birth weight children. Methods: The data of 36 cases with ultra-low birth weight (BMI) admitted to the Neonatal Intensive Care Unit of Meizhou People’s Hospital from January 2015 to July 2016 were collected. After birth, the children received ventilator-assisted breathing via endotracheal intubation, After weaning, the rats were randomly divided into two groups according to random number table, control group (n = 16), nasal continuous positive airway pressure therapy (NCPAP), observation group (n = 20) and humidification high flow nasal catheter ventilation HHFNC). The failure rate of extubation, the incidence of complications and the duration of ventilation were observed and compared between the two groups in 7 days. Results: There was no significant difference in the failure rate of extubation, the time of ventilatory treatment and the incidence of pulmonary air leak and bronchopulmonary dysplasia between the two groups in 7 days (P> 0.05). The incidence of nasal injury and bloating in observation group was significantly higher Lower than the control group (P <0.01). Conclusion: Wetting high-flow nasal catheter ventilation can effectively prevent extubation of ultra-low birth weight children, reduce the incidence of nasal injury and bloating, and improve the comfort of children.