高频震荡通气治疗新生儿呼吸窘迫综合征的临床效果分析

Clinical effective analysis of high frequency oscillatory ventilation in treatment of neonatal respiratory distress syndrome

目的:观察高频震荡通气(HFOV)治疗新生儿呼吸窘迫综合征的临床效果。方法:对1997年1月～2007年6月本科收治的848例早产儿肺透明膜病(NRDS)和248例新生儿急性呼吸窘迫综合征(ARDS)患儿进行临床对照研究,采用HFOV治疗的患儿为病例组(包括NRDS516例,ARDS156例),将给予持续低流量吸氧、面罩吸氧或持续气道正压(CPAP)治疗的患儿列为对照组(包括NRDS332例,ARDS92例)。分别比较2组患儿治疗前及治疗后24、72h血气分析结果、住院天数、治愈率及并发症发生的差异。结果:病例组患儿上机后24、72h氧分压(PaO2)、pH值较对照组明显上升,二氧化碳分压(PaCO2)、氧合指数(OI)明显下降,治愈率较对照组明显增加,且住院天数及并发症发生率明显减少,差异均有统计学意义(P<0.05)。结论:HFOV改善通气效果明显,氧合指数改善快,可提高治愈率,缩短住院时间,减少并发症,是一种安全、有效的新型通气方式。

Objective： To evaluate the efficacy and safety of high frequency oscillatory ventilation （HFOV） in treatment of neonatal respiratory distress syndrome（NRDS） and neonatal acute respiratory distress syndrome（ARDS）. Methods： Eight hundred and forty eight cases infants with NRDS and 248 cases with ARDS from Jan. 1997% Jun. 2007 were enrolled in the comparing study. The infants treated by HFOV were regarded as case group （516 cases with NRDS,156 cases with NRDS）, the cases inhaled oxygen with nasal catheter, face mask, or CPAP were regarded as control group （332 cases with NRDS, 92 cases with ARDS）. Their difference according to blood-gas analysis, days in hospital, successful rate and complica- tions were compared. Results： After 24 and 72 hours of treatment, PaO2, pH were significant improved and PaCO2, OI were greater descended in case group. Successful rate was higher in case group. Days in hospital and complications of case group were lower than control group （P 〈0.05）. Conclusion： HFOV is efficient and safe for the treatment of NRDS and ARDS. It can rapidly improve oxygenation, decrease complication and hospitalization time. HFOV is a new kind of safe and effective ventilation mode.