容量目标通气与高频振荡通气治疗新生儿呼吸窘迫综合征的疗效比较

Comparison of the efficacy of volume-targeted ventilation and high frequency oscillatory ventilation in treatment of neonatal respiratory distress syndrome

目的比较容量目标通气(VTV)与高频振荡通气(HFOV)治疗新生儿呼吸窘迫综合征(NRDS)的疗效。方法将2015年9月至2017年12月该院收治的50例NRDS患儿分为VTV组和HFOV组,每组25例。VTV组采用常频机械通气(CMV)+目标潮气量(TTV)模式,HFOV组采用HFOV模式。试验开始后6、24、48h检查动脉血气分析,记录病死率、氧疗时间、有创通气时间,以及低碳酸血症、肺气漏、呼吸机相关性肺炎(VAP)、脑室周围白质软化(PVL)、Ⅲ~Ⅳ级脑室周围-脑室内出血(PVH-IVH)、早产儿视网膜病变(ROP)、支气管肺发育不良(BPD)的发生率。结果VTV组低碳酸血症和PVL的发生率均低于HFOV组,差异有统计学意义(P<0.05);而2组病死率、氧疗时间、有创通气时间及肺气漏、VAP、Ⅲ~Ⅳ级PVH-IVH、ROP、BPD的发生率比较,差异均无统计学意义(P>0.05)。结论VTV治疗NRDS的疗效优于HFOV。

ObjectiveTo compare the efficacy of volume-targeted ventilation(VTV)and high frequency oscillatory ventilation(HFOV)in treatment of neonatal respiratory distress syndrome(NRDS).MethodsFifty cases NRDS from September 2015 to December 2017 were randomly divided into VTV group and HFOV group,25 cases in each group.CMV+TTV ventilation model was applied in the VTV group,and HFOV ventilation model was applied in the HFOV group.Arterial blood gas analysis was performed at 6,24,48 h after ventilation.The mortality,duration of oxygen therapy,time of invasive mechanical ventilation,and the incidence rates of hypocapnia,pulmonary air leak,ventilator-associated pneumonia(VAP),periventricular leukomalacia(PVL),Ⅲ-Ⅳperiventricular-intraventricular hemorrhage(PVH-IVH),retinopathy of prematurity(ROP),bronchopulmonary dysplasia(BPD)were recorded.ResultsCompared with the HFOV group,the VTV group had significantly lower incidence rates of hypocapnia and PVL,the differences were statistically significant(P<0.05);however,there were no significant differences in the mortality,duration of oxygen therapy,time of invasive mechanical ventilation,and incidence rates of pulmonary air leak,VAP,Ⅲ-ⅣPVH-IVH,ROP and BPD(P>0.05).ConclusionVTV has a better efficacy than HFOV in the treatment of NRDS.