目的 研究加热湿化高流量鼻导管辅助通气 (HHFNC) 在治疗新生儿呼吸窘迫综合征中的作用.方法将出生体质量≤1 500 g且临床诊断新生儿呼吸窘迫综合征的43例新生儿随机分配到HHFNC组和鼻塞式持续性气道正压通气(NCPAP) 组,比较两组在无创通气时间、机械通气使用、气胸及BPD发生率等方面的差异.结果无创通气时间,HHFNC组为 (4.43±3.42) d;NCPAP组 (3.95±3.23) d;机械通气使用,HHFNC组6例 (30%);NCPAP组6例 (26.1%);气胸,HHFNC组1例 (5%),NCPAP组3例 (13%);BPD,HHFNC组2例 (10%),NCPAP组3例 (13%),两组间差异均无统计学意义 (P 均>0.05).结论 HHFNC在治疗新生儿呼吸窘迫综合征方面的作用与NCPAP相当,在无创通气时间、机械通气使用、气胸发生率和BPD发生率方面的差异均无统计学意义,可以有效的应用于临床.%Objective To investigate the effect of heated humidified high flow nasal cannular (HHFNC) on neonatal respiratory distress syndrome. Methods Forty-three infants whose birth weight were not more than 1 500 grams and who were diagnosed with neonatal respiratory distress syndrome were randomly assigned into HHFNC group and continuous positive airway pressure (NCPAP) group. The duration of non-invasive ventilation and the incidence rates of invasive ventilation use, pneumothorax and bronchopulmonary dysplasia were compared between two groups. Results The duration of non-invasive ventilation was (4.43±3.42) days in HHFNC group and (3.95±3.23) days in NCPAP group. The incidence of invasive ventilation use was 6 cases (30%) in HHFNC group and 6 cases (26.1%) in NCPAP group. The incidence of pneumothorax was 1 case (5%) in HHFNC group and 3 cases (13%) in NCPAP group. The incidence of bronchopulmonary dysplasia was 2 cases (10%) in HHFNC group and 3 cases (13%) in NCPAP group. There is no significant difference between two groups in these outcomes. Conclusions HHFNC has the same effect as NCPAP in the treatment of neonatal respiratory distress syndrome. There is no significant difference on the duration of non-invasive ventilation and the incidence rate of invasive ventilation use, pneumothorax and bronchopulmonary dysplasia between two groups.
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