高频震荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征临床观察

Clinical Observation of High Frequency Oscillation Ventilation Combined with Pulmonary Surfactant in Treatment of Neonatal Respiratory Distress Syndrome

目的:探讨高频震荡通气(HFOV)联合肺表明活性物质(PS)治疗新生儿呼吸窘迫综合征(NRDS)的疗效。方法:对25例NRDS患儿采用常规通气(CMV)联合PS治疗(CMV组),20例采用HFOV联合PS治疗(HFOV组)。结果:两组患儿在上机前,反映氧合功能的FiO2、OI、PaA三个参数统计学差异。HFOV组患儿经治疗2 h后FiO2和OI显著下降,Pa/A升高,CMV组患儿呈现相似的改变,但不如HFOV组显著,随着时间推移,两组之间差异更明显。HFOV组上机时间(74±10)h,CMV组上机(85±9)h,两组时间比较,有统计学意义(P<0.05)。HFOV组存活率85.7%,CMV组存活率84%,有统计学意义(P<0.05)。结论:高频震荡通气联合肺表明活性物质治疗新生儿呼吸窘迫综合征可改善氧合,减少上机时间,提高存活率。

Objective：To explore the therapeutic effect of the combined use high trequency oscillatory ventliation （HFOV） with pulmonary surfactant（PS） in Treatment of neonatal respiratory distress syndrome（NRDS）. Methods：25 infants with NRDS were treated with conventional mandatory ventilation （CMV） combined with PS, 28 infants were treated with HFOV combined with PS. Results ：Before ventilation there was no statistical difference between the groups as to the parameter of FiO2,OI, Pa/A, P〉0.05. After 2 hours ventilation,FiO2 and OI reduced significantly and Pa/A risen in the HFOV group.The similar change was seen in the CMV group,but the change was not striking compared with HFOV group. And the change was more significant as time lapsed. Duration of ventilation in the HFOV group was 74 h±10 h,and 85 h±9 h in the CMV group,there was statistical significance（P〈0.05）. The survival rate was 92.8% in the HFOV and 72 in the CMV ,there was statistical significance（P〈0.05）. Conclusion：the combined use of HFOV with PS can improve the oxygenation and reduced the duration of ventilation in the patients with NRDS,as well as increasing survival rates.