肺表面活性物质联合高频震荡通气对新生儿呼吸窘迫综合征的临床疗效

Effect of lung surfactant and high-frequency oscillatory ventilation in treating neonatal respiratory distress syndrome

目的：研究肺表面活性物质联合高频震荡通气对新生儿呼吸窘迫综合征的临床疗效。方法选择2012年1月至2016年3月在我院进行诊治的新生儿呼吸窘迫综合征患者82例,分为常频机械通气组（n =41）和高频震荡通气组（n =41）。常频机械通气组采用肺表面活性物质联合常频机械通气治疗,高频震荡通气组采用肺表面活性物质联合高频震荡通气治疗。比较2组患儿治疗前、后的临床症状、血气分析、治愈率、上机时间、住院时间和并发症发生情况。结果治疗前,2组PaCO 2、PaO 2、吸入氧浓度和氧合指数差异无统计学意义（P 值均〉0.05）,治疗后1、6、12、24 h高频震荡通气组 PaO 2明显高于常频机械通气组（P 值均〈0.05）,PaCO 2、吸入氧浓度和氧合指数明显低于常频机械通气组（P 值均〈0.05）；高频震荡通气组住院时间、上机时间和死亡率均明显低于常频机械通气组（P 值均〈0.05）；2组患儿最主要的并发症为新生儿硬肿症和肺炎,2组的并发症发生率差异无统计学意义（P 值均〉0.05）。结论肺表面活性物质联合高频震荡通气能明显改善新生儿呼吸窘迫综合征患儿的血气分析和氧合指数,缩短机械通气治疗时间及住院时间,值得应用推广。

Objective To study the effect of lung surfactant and high-frequency oscillatory ventilation in treating neonatal respiratory distress syndrome.Methods 82 cases of neonatal respiratory distress syndrome from January 2012 to March 201 6 were selected and divided into conventional ventilation group （n = 41） and high-frequency oscillatory ventilation group （n = 41）.The clinical symptoms,blood gas analysis,cure rate,the computer time,length of hospital stay,and complications were compared.Results After treatment 1 h,6 h,12 h,24 h,PaO 2 in high-frequency oscillation ventilation group was higher than that in conventional ventilation group （all P 〈 0.05）,PaCO 2 ,inhaled oxygen concentration and oxygenation index in high-frequency oscillation ventilation group were lower than those in conventional ventilation group （all P 〈0.05）.Compared with conventional ventilation group,hospital stay and mortality were significantly lower in high-frequency oscillation ventilation group （all P 〈0.05）. The incidence of complications had no obvious difference between the two groups （all P 〉 0.05）. Conclusions Lung surfactant and high-frequency oscillatory ventilation can improve the blood gas analysis and oxygenation index,shorten the mechanical ventilation treatment time and hospital stay,is worth application.