高频震荡通气治疗重症新生儿缺氧缺血性脑病并呼吸衰竭

Effects of high frequency oscillatory ventilation in the newborn hypoxic-ischemic encephalopathy with respiratory failure

目的探讨高频振荡通气在新生儿严重缺氧缺血性脑病(HIE)并呼吸衰竭的临床应用。方法21例重症HIE并呼吸衰竭新生儿经常规机械通气(CMV)治疗失败后改为HFOV治疗,治疗过程中监测经皮测氧饱和度、动脉血气及氧合指数、动脉肺泡氧分压(a/A)等。结果21例患儿用HFOV治疗2h后FiO2明显下调,a/APaO2比值升高,差异有统计学意义(P<0.05);至6h后差异有统计学意义(P<0.01);且未出现肺气压伤、支气管肺发育不良等后遗症。结论重症HIE用CMV无效后改用HFOV可获得显著疗效。

Objective To evaluate the effects of high frequency oscillatory ventilation （HFOV） in the hypoxic-ischemie encephalopathy （HIE） with respiratory failure. Methods Twenty-one newborns with severe HIE with respiratory failure performed the HFOV after failure of conventional mechanical ventilation （CMV）. The O2 saturation, the ratio of a/A PaO2 ,arterial blood gas and oxygenation index were monitored in the course of HFOV. Results The FiOz reduced significantly after 2 hours HFOV, the ratio of a/A PaO2 increased significantly （P〈0.05）, and the change was high significantly after 6 hours HFOV （P〈0.01）. There was no the adverse effect of pulmonary barotraumas and bronchopulmonary dysplasia. Conclusion HFOV is an effective method for neonatal infants with severe HIE and respiratory failure after failure of CMV.