高频振荡通气治疗新生儿气胸疗效观察

Efficacy observation of 18 neonates with pneumothorax treated by high frequency oscillatory ventilation

目的 评价高频振荡通气 (HFOV)并胸腔闭式引流治疗新生儿气胸的疗效。方法 18例出现气胸的新生儿采用高频振荡通气并胸腔闭式引流治疗 ,观察其治疗前后血气指标的变化及临床疗效。结果 治疗 12h后PaCO2 由 (10 .10± 3 .2 0 )kPa下降至 (5 .70± 0 .80 )kPa(P <0 .0 5 ) ,PaO2 由 (5 .60±1.10 )kPa上升至 (7.2 0± 1.60 )kPa(P <0 .0 5 ) ,2 4h后PaO2 为 (9.3 0± 2 .0 0 )kPa(P <0 .0 1) ,并且FiO2 和氧合指数、平均气道压等均逐渐下降。经HFOV并闭式引流治疗 ,18例气胸患儿完全治愈 14例 ,放弃治疗 3例 ,1例双侧气胸患儿无效。结论 HFOV对治疗新生儿气胸并呼吸衰竭十分有效 ,且安全性好 ,比常频机械通气 (CMV)有很大优越性。

Objective To evaluate the therapeutic effect of high frequency oscillatory ventilation (HFOV) combined with thoracic cavity occlusive drainage on neonatal pneumothorax.Methods 18 neonates with pneumothoax were treated by HFOV combined with thoracic cavity occlusive drainage.The clinical efficacy was observed and blood gas parameters were detected before and after treatment.Results 12 hours after treatment,the PaCO 2 decreased from (10.10±3.20) kPa to (5.70±10.80) kPa (P<0.05),the PaO 2 increased from (5.60±1.10) kPa to (7.20±1.60) kPa (P<0.05).24 hours after treatment,PaO 2 was (9.30±2.00) kPa (P<0.01),and FiO 2,oxygenation index and mean airway pressure decreased gradually.18 neonates were treated by HFOV and thoracic cavity occlusive drainage.14 cases were cured completely.3 cases gave up treatment and one case of bilateral pneumothorax had no effect.Conclusion HFOV is safe and quite effective in treating neonatal pneumothorax with acute respiratory failure, which is superior to conventional mechanical ventilation (CMV).