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高频振荡通气治疗新生儿肺出血的临床研究 被引量:4

Clinical study of high - frequency oscillatory ventilation in the treatment of pulmonary hemorrhage in newborn infants
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摘要 目的探讨高频振荡通气治疗新生儿肺出血的临床疗效。方法选取56例肺出血新生儿,其中高频振荡通气(HFOV)组28例,常规机械通气(CMV)组28例,在常规治疗的基础上,HFOV组接受高频振荡通气治疗,CMV组接受常规通气治疗,观察并记录两组患儿的呼吸机参数,计算氧合指数(0I)和动脉/肺泡氧分压比(a/APaO2),比较两组患儿的肺出血时间、上呼吸机机时间、机械通气时间、住院时间。结果治疗前两组患儿OI和~APaO:之间的差异均无统计学意义(t1=0.28,P,=0.78,t2=0.47,P2=0.64),通气治疗1h后,仍存活患儿的0I值不断下降,a/APaO2不断升高,但HFOV组治疗效果相较于CMV组更加明显,差异均有统计学意义(t1’=2.14,P1’=0.04,t2’=2.26,P2’=0.03)。HFOV组中治愈23例(82.1%),死亡5例(17.9%),CMV组中治愈15例(53.6%),死亡13例(46.4%)。HFOV组患儿的肺出血时间、上机时间、氧疗时间和住院时间都明显低于CMV组,差异均有统计学意义(P=0.046、0.044、0.048、0.035)。结论HFOV能更好地改善肺出血患儿氧合功能,缩短病程,提高治愈率,推荐应用与临床治疗。 Objective To investigate the effects of high frequency oscillatory ventilation in the treatment of neonatal pulmonary hemorrhage curative. Methods 56 neonates with pulmonary hemorrhage were selected,28 cases in high frequency mechanical ventilation(HFOV) group and 28 cases in conventional mechanical Ventilation(CMV) group. On the basis of conventional treatment,the HFOV group received high -frequency mechanical ventilation therapy, the EMV group treated with conventional ventilation. The breathing machine parameters of the two groups were observed and recorded calculated oxygenation index ( OI ) and arterial^alveolar oxygen partial pressure ratio (a/APaO2). The duration of pulmonary hemorrhage, the duration of mechanical ventilation, the length of hospital stay, and the duration of oxygen therapy were compared between the two groups. Results Before treatment, there were no statistically differences of in OI and a/APaO2 between the two groups ( t1 = 0.28, Pl = 0.78 ; t2 = 0.47, P2 = 0. 64), lh treatment later,declining value of the OI and the rising of a/APaO2 in Surviving children,and the therapeutic effect of the HFOV group were more obvious than those of the CMV group (t1' = 2.14, P1' = O. 04 ; t2' = 2.26, P2' = 0.03 ). In the HFOV group,23 cases cured(82.1% ) ,5 cases died( 17.9% ). And in CMV group,15 cases cured(53.6% ) , 13 cases died(46.4% ). The duration of pulmonary hemorrhage,the duration of mechanical ventilation,the length of the hospital stay, and the duration of oxygen therapy of the HFOV group were significantly lower than those of CMV group, the differences were statistically significant ( P = 0. 046,0.044,0.048,0. 035 ). Conclusion HFOV can better improve oxygenation function in infants with pulmonary hemorrhage, shorten the course of the disease and improve the cure rate, recommend the application and clinical treatment.
出处 《中国基层医药》 CAS 2017年第7期1015-1019,共5页 Chinese Journal of Primary Medicine and Pharmacy
关键词 高频通气 急性肺损伤 出血 婴儿 新生 High-frequency ventilation Acute lung injury Hemorrhage Infant,newborn
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