高频振荡通气治疗重症新生儿呼吸窘迫综合征疗效分析

Therapeutic effect of high frequency oscillatory ventilation in the treatment of severe neonatal respiratory distress syndrome

目的探讨高频振荡通气治疗重症新生儿呼吸窘迫综合征的疗效。方法将31例选择传统常频机械通气治疗者定为常频组;38例选择高频震荡通气治疗者定为高频组,比较两组的疗效。结果两组治疗48h以上与同组0h各项(氧浓度、平均气道压、动脉血氧分压、动脉二氧化碳分压、经皮血氧饱和度及氧和指数)对比均有显著性差异,常频组x^2值依次为8.68、4.30、9.18、5.62、7.09、2.61;高频组x^2值依次为12.74、10.56、14.43、7.55、5.89、3.07,均P<0.05;高频组治疗25~48h与0h各项对比均有显著性差异,x^2值依次为5.31、6.94、9.92、4.96、4.45、2.04,均P<0.05。两组其它时间段各项指标与0h对比差异均无统计学意义(均P>0.05)。常频组总有效率为87.10%,高频组总有效率为94.74%;无效病例均为出现严重并发症,经抢救无效死亡的患儿;两组总治愈率与死亡率比较均无显著性差异(均P>0.05)。结论高频振荡通气治疗重症新生儿呼吸窘迫综合征疗效明显优于常频通气,值得临床推广应用。

Objective To explore the therapeutic effect of high fi＇equency oscillatory ventilation in the treatment of severe neonatal respiratory distress syndrome（RDS）. Methods Thirty-one cases choosing normal frequency mechanical ventilation were taken in normal frequency group, and another 38 cases selecting high frequency oscillatory ventilation were defined in high frequency group. The efficacy of two groups was compared. Results Every index of both groups after 48h treatment was significantly different from that at Oh （oxygen concentration, mean airway pressure, arterial partial pressure of oxygen, partial pressure of carbon dioxide artery, transcutaneous oxygen saturation, oxygen index） （χ2 value was 8.68, 4.30, 9.18, 5.62, 7.09 and 2.61, respectively in normal frequency group and 12.74, 10.56, 14.43, 7.55, 5.89 and 3.07, respectively in high frequency group, all P 〈 0.05 ）. Every index of high frequency group after 25- 48h treatment was significantly different from that at Oh （χ2 value was 5.31, 6.94, 9.92, 4.96, 4.45 and 2.04, respectively, all P 〈 0.05 ）. There was no statistical difference between the indexes at other time and those at Oh （ all P 〉 0.05 ）. The total effective rate of high frequency group and normal frequency group was 94. 74% and 87. 10%, respectively. Invalid cases were neonates with severe complications and died after rescue. The total cure rate and mortality were not significantly different between two groups （ all P 〉 0.05 ）. Conclusion The therapeutic effect of high frequency oscillatory ventilation in the treatment of severe neonatal RDS is superior to normal frequency ventilation, and it is worthy of clinical application.