经鼻持续气道正压通气与经鼻无创高频振荡通气在新生儿胎粪吸入综合征机械通气撤机中的应用

doi:10.20047/j.issn1673-7210.2023.24.25

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Abstract Objective To explore the application of nasal continuous positive airway pressure (NCPAP) and nasal non- invasive high-frequency oscillatory ventilation (NHFOV) in mechanical ventilation weaning of neonatal meconium aspiration syndrome (MAS). Methods A total of 80 newborns with MAS admitted to the Department of Neonatology, Fuyang Women’s and Children’s Hospital, Anhui Province from May 2019 to May 2022 were selected as the research objects. They were divided into NCPAP group and NHFOV group, with 40 cases in each group. MAS children of two groups were respectively given NCPAP and NHFOV respiratory support after mechanical ventilation weaning. The blood gas index (partial pressure of oxygen in arterial blood [PaO2], partial pressure of carbon dioxide in arterial blood [PaCO2], PaO2/inspired oxygen concentration [FiO2]) were compared between two groups before weaning and after weaning at 1, 12, 24 h; non-invasive breathing time, total gastrointestinal nutrition time, weaning failure rate, and complications were compared between two groups. Results PaO2, PaO2/FiO2 at different time between two groups were statistically significant (P＜0.01); PaCO2 at different time, intergroup, and interaction between two groups were statistically significant (P＜0.01). Comparison within groups: after weaning at 1, 24 h, PaO2 in both groups were higher than those before weaning; after weaning at 24 h, PaO2/FiO2 in two groups were higher than those before weaning, and the differences were statistically significant (P＜0.05). After weaning at 12, 24 h, PaCO2 of NCPAP group were lower than those before weaning; after weaning at 1, 12, 24 h, PaCO2 of NHFOV group were higher than those before weaning, and the differences were statistically significant (P＜0.05). Comparison among groups: after weaning at 1, 12, 24 h, there were no significant differences in PaO2 and PaO2/FiO2 between two groups (P＞0.05); PaCO2 in NHFOV group was lower than that in NCPAP group, and the difference was statistically significant (P＜0.05). The weaning failure rate of NHFOV group was lower than that of NCPAP group, and the difference was statistically significant (P＜0.05); there were no significant differences in non-invasive breathing time and total gastrointestinal nutrition time between two groups (P＞0.05). The total complication rate of NHFOV group was lower than that of NCPAP group, and the difference was statistically significant (P＜0.05). Conclusion Compared with NCPAP, the application of NHFOV in mechanical ventilation weaning of neonatal MAS children is more conducive to reducing PaCO2 and reducing the weaning failure rate.

Key words： Nasal continuous positive airway pressure ventilation Nasal non-invasive high-frequency oscillatory ventilation Newborn Meconium aspiration syndrome Blood gas index

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	LIU Hong WANG Xinrui LI Shuai▲

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LIU Hong WANG Xinrui LI Shuai▲. Application of nasal continuous positive airway pressure ventilation and nasal non-invasive high-frequency oscillatory ventilation in mechanical ventilation weaning of neonatal meconium aspiration syndrome[J]. 中国医药导报, 2023, 20(24): 105-108,120.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.24.25 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I24/105

[1] 贾玲，曹岚，兰芙蓉.气管内滴入牛肺表面活性物质辅助经鼻双相正压通气模式治疗胎粪吸入综合征的疗效[J].儿科药学杂志，2021，27（5）：18-21.
[2] 徐潜，迟姗姗，郝丹丹，等.高频振荡通气联合肺表面活性物质治疗新生儿胎粪吸入综合征效果分析[J].实用临床医药杂志，2020，24（14）：60-62，66.
[3] 吴雪红，李淼，施学文，等.早期联合雾化吸入对胎粪吸入综合征机械通气患儿氧合功能及炎症指标的影响[J].临床肺科杂志，2020，25（1）：131-134.
[4] 毕雷，黄国盛，黄培禄，等.不同通气模式联合猪肺磷脂注射液对新生儿胎粪吸入综合征并肺动脉高压的疗效[J].国际呼吸杂志，2021，41（10）：777-782.
[5] 高晓燕，冯琳，邱玉芬，等.加温湿化高流量鼻导管通气在胎粪吸入综合征并肺动脉高压机械通气撤机中的应用研究[J].中国当代儿科杂志，2017，19（4）：393-397.
[6] 张佩，夏世文，祝华平，等.经胃管微创注入肺表面活性物质技术治疗新生儿呼吸窘迫综合征的效果[J].中国医药导报，2020，17（6）：95-98，114.
[7] 霍美池，戴瑞芝，李峥.经鼻无创高频呼吸机对ELBW早产儿的疗效分析[J].中国妇幼健康研究，2022，33（5）：72-77.
[8] 邵肖梅，叶鸿瑁，邱小汕.实用新生儿学[M].4版.北京：人民卫生出版社，2011：398-401.
[9] 《中华儿科杂志》编辑委员会，中华医学会儿科学分会新生儿学组.新生儿机械通气常规[J].中华儿科杂志，2015， 53（5）：327-330.
[10] 陈文超，程红斌.新生儿重症胎粪吸入综合征呼吸机联合肺表面活性物质治疗的疗效及预后分析[J].湖南师范大学学报（医学版），2018，15（3）：153-155.
[11] 张霞，黄奕霖，段玉会，等.高频振荡通气联合猪肺磷脂注射液治疗新生儿胎粪吸入综合征并肺动脉高压的临床效果[J].临床和实验医学杂志，2022，21（8）：874-878.
[12] 郝玉贵，周江平.注射用牛肺表面活性剂双途径给药在重症新生儿胎粪吸入综合征中的应用[J].中国药物与临床，2022，22（2）：157-160.
[13] 边兆敏，王军.两种无创通气模式治疗新生儿胎粪吸入综合征的疗效分析[J].中国现代医学杂志，2020，30（24）： 66-71.
[14] 管娟，曾峰.肺表面活性物质联合呼吸机机械通气治疗新生儿重症胎粪吸入综合征的疗效[J].结直肠肛门外科，2021，27（2）：32-33.
[15] 黎敏，刘润宁.肺泡表面活性物质联合机械通气对胎粪吸入综合征患儿肺功能影响[J].现代仪器与医疗，2017， 23（4）：119-120，130.
[16] 张瑞敏.重度新生儿呼吸窘迫综合征死亡的危险因素Logistic回归分析及治疗建议[J].湖南中医药大学学报，2018，38（1）：690-691.
[17] 何焱志，李艳娟.机械通气撤机后序贯经鼻持续气道正压通气高流量鼻导管湿化氧疗在新生儿肺炎合并呼吸衰竭治疗中的疗效差异[J].河北医学，2020，26（7）：1148- 1152.
[18] 王帆，文革生，蒋琦.早产儿高流量鼻导管通气在机械通气撤机中的效果及对血气分析的影响[J].中国医师进修杂志，2020，43（5）：444-447.
[19] 高亚，陈信，张阵，等.经鼻持续气道正压通气与振动网格雾化吸入肺表面活性物质联合治疗新生儿呼吸窘迫综合征的疗效和安全性[J].中华危重病急救医学，2022， 34（1）：80-84.
[20] 薛洁英，王有禄，吕智敏，等.肺表面活性物质联合经鼻持续气道正压通气治疗对新生儿呼吸窘迫综合征患儿血气指标及预后的影响[J].中国医药科学，2021，11（22）：80-82，124.
[21] Zhu X，Feng Z，Liu C，et al. Nasal High-Frequency Oscillatory Ventilation in Preterm Infants with Moderate Respiratory Distress Syndrome：A Multicenter Randomized Clinical Trial [J]. Neonatology，2021，118（3）：325-331.
[22] 赵金章，刘玲，张莉，等.无创高频振荡通气与经鼻持续气道正压通气在新生儿呼吸窘迫综合征初始治疗中的疗效评价[J].陕西医学杂志，2019，48（11）：1461-1463， 1467.
[23] 刘颖，聂川，颜慧恒，等.经鼻无创高频振荡通气与持续气道正压通气在早产儿呼吸窘迫综合征初始治疗中的效果比较[J].广东医学，2020，41（3）：229-233.
[24] 李欢欢，朱兴旺，汪万军.无创高频振荡通气在早产儿有创机械通气撤机后呼吸支持效果的随机对照研究[J].第三军医大学学报，2019，41（17）：1688-1692.
[25] 杨丽，易明，彭周杰，等.无创高频振荡通气在极低出生体质量儿呼吸窘迫综合征的早期应用[J].中华实用儿科临床杂志，2021，36（20）：1555-1558.
[26] 郭之强，陈丽萍，陶荔，等.应用NHFOV预防新生儿拔管失败的临床研究[J].中国当代医药，2021，28（23）：127-130.