高频振荡通气治疗新生儿持续肺动脉高压的临床研究

CLINICAL RESEARCH OF HIGH FREQUENCY OSCILLATORY VENTILATION IN TREATMENT OF PERSISTENT PULMONARY HYPERTENSION OF NEWBORN

目的探讨高频振荡通气治疗新生儿持续肺动脉高压的疗效和安全性。方法对收治的63例新生儿持续肺动脉高压患儿的资料行回顾性分析,将其分为观察组(高频振荡通气)和对照组(常频机械通气),并对二组患儿的一般资料、疗效等数据行统计分析。结果二组比较,观察组羊水胎粪污染发生率较高;二组的胎粪吸入性肺炎差异有统计学意义(P<0.05);观察组肺动脉高压的程度较对照组重(P<0.05);观察组行机械通气后的血气分析结果较通气前明显改善(P<0.01);机械通气后二组比较,观察组的吸氧浓度更低(P<0.05);硫酸镁的使用率和合并颅内出血的比较,二组差异无统计学意义(均P>0.05);发生气胸且使用胸腔闭式引流的的比较,观察组较对照组低(P<0.05)。结论高频振荡通气治疗新生儿持续肺动脉高压疗效明显,且在发生气胸时能减少胸腔闭式引流的使用,治疗的同时不增加颅内出血的发生率,值得临床推广应用。

Objective To explore the curative effect and safety of high frequency oscillatory ventilation in treatment of persistent pulmonary hypertension of newborn.Methods Sixty three cases with persistent pulmonary hypertension of newborn who were treated in NICU from February 2011 to January 2014,they were involved in this study and divided into therapy group（high frequency oscillatory ventilation）and control group（conventional mechanical ventilation）.The clinical data were analyzed.Results Meconium stained amniotic fluid was higher in therapy group,the meconium aspiration pneumonia（MAS）was significantly difference between two groups（P〈0.05）.Pulmonary hypertension of newborn in therapy group was more severe than that in control group（P〈0.05）.In therapy group,the blood gas analyses improved significantly after ventilation（P〈0.01）.Between two groups,inhaled oxygen concentration（FiO2）of therapy group was lower after ventilation for 6~8 hours（P〈0.05）.There were not significantly different between two groups in MgSO4 application and incidence of intracranial hemorrhage（P〉0.05）.The pneumothorax and thoracic drainage of therapy group were lower than control group（P〈0.05）.Conclusion High frequency oscillatory ventilation is effetive in the treatment of newborns with persistent pulmonary hypertension and it may reduce the thoracic drainage when the newborns suffering from pneumothorax.Moreover,the risk of intracranial hemorrhage may not increase.It’s worth spreading.