高频震荡通气联合肺泡表面活性物质治疗新生儿呼吸窘迫综合征

NEONATAL RESPIRATORY DISTRESS SYNDROME TREATED WITH HIGH-FREQUENCY OSCILLATORY VENTILATION AND LUNG SURFACTANT COMBINING THERAPY

目的观察高频震荡通气(HFOV)联合肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征的临床疗效。方法回顾性分析2008年1月～2010年6月在我院儿科新生儿重症监护室(NICU)住院需机械通气治疗的38例新生儿呼吸窘迫综合征患儿的临床资料,其中20例给予HFOV+PS治疗,另外18例作为对照组给予常频通气(CMV)+PS治疗,比较两组之间的上机时间,上机后1、8、24 h的血气分析,上机后1、8、24 h的氧合指数,以及出现气漏等并发症的情况。结果 HFOV+PS组1、8、24 h的血气分析值及氧合指数明显优于CMV+PS组患儿。气漏、慢性肺部疾病发生率前者明显低于后者。结论 HFOV+PS较经典的CMV+PS治疗新生儿呼吸窘迫综合征在改善氧合方面更快速,更高效,能更快地下调氧浓度,缩短上机时间,肺部并发症相对较少。

Objective To observe the clinical efficacy of high -frequency oscillatory ventilation and lung surfactant combining therapy treating neonatal respiratory distress syndrome. Methods Analyzing retrespeetively the clinical data of 38 new - born baby respiratory distress syndrome in our neonatal intensive care unit who needed mechanical ventilation treatment during January 2008 to June 2010. The 20 cases were given high -frequency oscillatory ventilation combined with lung surfactant therapy. While, as control group, the otherl 8 cases were given normal - frequency ventilation combined lung surfactant therapy. Compare two groups＇ mechanical ventilating time,the blood gas analysis and the oxygenation index after giving mechanical ventilating 1 hours,8 hours,24 hours. Observe the emergence of complications such as air leak case. Results The high - frequency oscillatory ventilation combined with lung surfactant group were significantly better than the CMV group on the clinical indices of 1 hours,8 hours,24 hours blood gas analysis and oxygenation index. The emergence of complications such as gas leak and the incidence of chronic lung disease were the former less than the latter. Conclusion On the treatment of neonatal respiratory distress syndrome, HFOV ＋ PS was better than CMV ＋ PS. The former improve the oxygenation faster, downgrade the oxygen concentration more efficiently, reduce machine time and the emergence of pulmonary complications.