摘要
目的:比较经鼻高流量氧疗(HFNC)与经鼻持续气道正压通气(nCPAP)治疗毛细支气管炎的疗效。方法:选取HFNC治疗的88例毛细支气管炎作为HFNC组,nCPAP治疗的91例毛细支气管炎患儿作为nCPAP组,比较两组不同时间的呼吸频率、心率、动脉血二氧化碳分压、氧合指数,并对两组患儿鼻粘膜损伤的发生率、腹胀发生率、鼻饲率及气管插管率进行比较。结果:两组呼吸、心率、动脉血二氧化碳分压、氧合指数均较治疗前改善(P<0.05),但nCPAP组在治疗2 h、24 h、48 h氧合指数较HFNC组改善更明显(P<0.05);HFNC组鼻粘膜损伤、腹胀、需鼻饲情况明显低于nCPAP组(P<0.05),两组气管插管率比较,差异无统计学意义(P>0.05)。结论:HFNC与nCPAP均能改善毛细支气管炎患儿的呼吸窘迫、氧合及换气功能。与nCPAP相比,HFNC具有良好的舒适度,腹胀及鼻黏膜损伤的发生率低,能耐受经口喂养,并不会增加毛细支气管炎的气管插管率;但对于氧合指数偏低的重症毛细支气管炎患儿,予以nCPAP治疗效果可能更佳。
Objective:To investigated the curative effects of high-flow nasal oxygen cannula(HFNC)compared with nasal continuous positive airway pressure(nCPAP)in the treatment of bronchiolitis.Methods:88 children with severe bronchiolitia treated with HFNC were selected as HFNC group,and 91 children with severe bronchioliti treated with nCPAP were selected as nCPAP group,the respiratory rate(RR),heart rate(HR),arterial carbon dioxide(PaCO 2)and oxygenation index(PaO 2/FiO 2)of the two groups were compared at different time points,and the incidence of nasal mucosal damage,abdominal distention,nasal feeding and tracheal intubation during the process of treatment were compared between the two groups.Results:After treatment,RR,HR,PaCO 2 and PaO 2/FiO 2 were significantly improved in both groups(P<0.05),however,PaO 2/FiO 2 in the nCPAP group were better than that in the HFNC group at different time points(2,24 and 48h)(P<0.05),Compared with the nCPAP group,the incidence of nasal mucosal damage,abdominal distention and nasal feeding were lower in the HFNC group(P<0.05),there were no significant difference in incidence of tracheal intubation between the two groups(P>0.05).Conclusion:HFNC and nCPAP could effectively improve the respiratory distress,oxygenation and gas exchange function of the children in severe bronchiolitis.Compared with the nCPAP,HFNC is associated with more comfort,and significantly reduced incidence of abdominal distension and nasal mucosal damage,and can tolerate oral feeding in the process of treatment,moreover,HFNC did not increase the incidence of tracheal intubation in severe bronchiolitis,however,for children with severe bronchiolitis whose PaO 2/FiO 2 is low,nCPAP may be a more suitable treatment option.
作者
沈玉才
许志松
潘小苏
冯捷
冯金枝
SHEN Yu-cai;XU Zhi-song;PAN Xiao-su;FENG Jie;FENG Jin-zhi(PICU,the Fifth Affilitiated Hospital of Southern Medical University,Guangzhou 510900,Guangdong,China)
出处
《川北医学院学报》
CAS
2020年第1期88-91,共4页
Journal of North Sichuan Medical College
基金
南方医科大学第五附属医院院长基金项目(YZ2017MS2017002)。
关键词
经鼻高流量氧疗
经鼻持续气道正压通气
毛细支气管炎
气管插管
High-flow nasal oxygen cannula
Nasal Continuous Positive Airway Pressure
Bronchiolitis
Tracheal intubation
