高频振荡通气和常频机械通气治疗新生儿呼吸窘迫综合征的优劣差异

Difference between High Frequency Oscillatory Ventilation and Conventional Mechanical Ventilation in Treatment of Neonatal Respiratory Distress Syndrome

目的:观察高频振荡通气(HFOV)与常频机械通气(CMV)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效及安全性。方法:选取2017年12月-2018年10月本院收治的NRDS患儿61例。按照治疗方法不同将其分为对照组30例与观察组31例。两组均给予常规治疗,在此基础上,对照组接受CMV辅助治疗,观察组接受HFOV辅助治疗。比较两组治疗效果、并发症、机械通气时间、吸氧时间、住院时间,以及上机前后的动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、氧合指数(OI)。结果:两组治疗总有效率比较差异无统计学意义(P>0.05);观察组机械通气时间、吸氧时间及住院时间均短于对照组,比较差异均有统计学意义(P<0.05);上机后6、12、24 h,观察组PaO_2均高于对照组,PaCO_2、OI均低于对照组,比较差异均有统计学意义(P<0.05);观察组并发症发生率为3.2%,明显低于对照组的20.0%(P<0.05)。结论:HFOV治疗NRDS有较好的效果,可缩短通气时间、吸氧时间及住院时间,能有效提高新生儿肺氧合功能,并发症发生率更低,值得临床推广运用。

Objective:To observe the clinical efficacy and safety of high frequency oscillatory ventilation(HFOV)and conventional mechanical ventilation(CMV)in treatment of neonatal respiratory distress syndrome(NRDS).Method:A total of 61 children with NRDS admitted to our hospital from December 2017 to October 2018 were selected.According to different treatment methods,they were divided into control group(n=30)and observation group(n=31).Both groups were given routine treatment,on this basis,the control group received CMV adjuvant treatment,while observation group received HFOV adjuvant treatment.The therapeutic effect,complications,mechanical ventilation time,oxygen inhalation time,hospitalization time,PaCO2,PaO2 and oxygenation index(OI)before and after operation between two groups were compared.Result:The total effective rate in two groups was compared,the difference was not statistically significant(P>0.05).The mechanical ventilation time,oxygen inhalation time,hospitalization time in observation group were shorter than those of control group,the differences were statistically significant(P<0.05).At 6,12 and 24 hours after boarding the machine,the PaO2 in observation group was higher than that of control group,the PaCO2 and OI were lower than those of control group,the differences were statistically significant(P<0.05).The incidence of complications was 3.2%in observation group,which was significantly lower than 20.0%in control group(P<0.05).Conclusion:HFOV has a good effect on NRDS,can shorten mechanical ventilation time,oxygen inhalation time and hospitalization time,effectively improve neonatal pulmonary oxygenation function and lower the incidence of complications,which is worthy of clinical application.