高流量吸氧与CPAP在儿童先心病术后严重I型呼吸衰竭中支持作用的比较

doi:10.3969/j.issn.1006-6233.2019.07.028

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摘要目的: 比较高流量吸氧(HFNC)与CPAP在儿童先心病术后严重I型呼吸衰竭中的支持作用,提供更合理的支持方案。方法: 将我科2018年1月至2018年12月收治的44例先心病术后撤离呼吸机后出现严重I型呼吸衰竭的病例按照均衡随机化分组的方法随机分为HFNC组(22例)和CPAP组(22例),比较两组患儿的动脉氧分压(PaO₂)、经皮血氧饱和度(SpO₂)、动脉二氧化碳分压(PaCO₂)、呼吸频率(RR)、呼吸做功评分(RW评分)、再插管率、有创通气时间、ICU滞留时间、住院时间及舒适度评分、鼻压伤、腹胀、返流误吸、气漏的发生率有无差异。结果: HFNC组与CPAP组比较,PaO₂、SpO₂、再插管率、有创通气时间、ICU滞留时间、住院时间、气漏发生率无统计学差异;PaCO₂、RR、RW评分、舒适度评分及鼻压伤、腹胀、返流误吸的发生率低于CPAP组,有统计学差异。结论: 比较对儿童先心病术后严重I型呼吸衰竭患者的支持作用,HFNC优于CPAP。

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	宋航
	李青
	郭士勇
	武怡

关键词 ：高流量吸氧, CPAP, 术后, 先天性心脏病, I型呼吸衰竭

Abstract：Objective: To Compare the difference between the support effects of high-flow nasal cannula(HFNC) and CPAP in post-operative congenital heart disease(CHD) children with severe type I respiratory failure. Methods: From January 2018 to December 2018, 44 children were treated with HFNC (22 cases) and CPAP(22 cases) for severe type I respiratory failure after operation of congenital heart disease. PaO₂,SpO₂,PaCO₂,RR,RW score,duration of invasive ventilation, reintubation rate,duration of ICU,hospital stay,comfort score, nasal crush,abdominal distention,regurgitation and aspiration ,gas leakage are compared between the two groups. Results: Comfort score, PaCO₂,RR,RW score,nasal crush,abdominal distention,regurgitation and aspiration was lower in the HFNC group. There were no statistical significance in PaO₂,SpO₂,duration of invasive ventilation, reintubation rate,duration of ICU,hospital stay and gas leakage between the two groups. Conclusion: Comparing the support to post-operative children with CHD and severe type I respiratory failure,HFNC is better than CPAP.

Key words： High-flow nasal cannula CPAP Post-operative Congenital heart disease Type I respiratory failure

基金资助:江苏省卫生科研项目,(编号:H20140247)

通讯作者: 武怡

引用本文:

宋航, 李青, 郭士勇, 武怡. 高流量吸氧与CPAP在儿童先心病术后严重I型呼吸衰竭中支持作用的比较[J]. 河北医学, 2019, 25(7): 1158-1161.
SONG Hang , LI Qing, GUO Shiyong, Wu Yi. Comparison between High-flow Nasal Cannula and CPAP in Post-operative Congenital Heart Disease Children with Severe Type I Respiratory Failure. HeBei Med, 2019, 25(7): 1158-1161.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.07.028 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I7/1158