高频振荡通气治疗重症新生儿呼吸窘迫综合征的临床分析

Clinical analysis of high -frequency oscillatory ventilation in the treatment of severe neonatal respiratory distress syndrome

目的评价高频振荡通气在治疗重症新生儿呼吸窘迫综合征(NRDS)中的应用价值。方法 84例重症NRDS早产儿随机分为常频机械通气(CMV)组和高频振荡通气(HFOV)组,比较2组的血气指标、上机时间、住院时间、临床疗效及肺气漏(PAL)、支气管肺发育不良(BPD)、脑室内出血(IVH)等并发症的发生率。结果 HFOV组治疗2 h后动脉血氧分压(PaO2)明显上升,动脉血二氧化碳分压(PaCO2)、氧合指数(OI)明显下降,与CMV组比较差异有统计学意义(P<0.05)。2组治疗开始时、6 h、12 h、24 h的PaO2、PaCO2、OI比较差异均无统计学意义。HFOV组上机时间明显短于CMV组,差异有非常显著性(P<0.01)。2组PAL、BPD、IVH发生率、存活率及住院时间差异均无显著性(P>0.05)。结论 HFOV用于治疗重症新生儿呼吸窘迫综合征,能迅速改善肺呼吸功能,缩短上机时间,是一种疗效肯定、安全性好的机械通气方法。

Objective To study the value of HFOV in the trea-tment of severe NRDS. Methods Eighty-four preterm infants with severe NRDS were enrolled in the study and randomly divided into either CMV group or HFOV group.Blood gas values,duratian of mechanical ventilation and hospitalization,clinical efficacy,and incidence of mechanical ventilation complications were compared between two groups. Results Two hours after the HFOV therapy, PaO2was obviously increased and PaC02, OI were obviously decreased in the HFOV group, and the difference between the two groups was statistically significant （P〈0.05）.But there were no statistically significant in the difference of Pa02, PaC02 and OI on 0,6,12,24 hours after therapy between two groups. The duration of mechanical ventilation in HFOV group was significantly shorter than that in CMV group （P〈0.01）. There were no significant differences between the two groups in the duration of hospitalization , survival rates and incidences of PAL, BPD,IVH （P〉0.05）. Conclusion HFOV can rapidly improve pulmonary respiratory function, decrease the duration of mechanical ventilation. HFOV is a effective and safe mechanical ventilation method for severe NRDS.