无创高频振荡通气治疗新生儿呼吸窘迫综合征的效果及对PaO2、PaCO2的影响

Effect of Noninvasive High Frequency Oscillatory Ventilation in the Treatment of Neonatal Respiratory Distress Syndrome and Its Influence on PaO2 and PaCO2

目的:探究无创高频振荡通气治疗新生儿呼吸窘迫综合征(NRDS)的临床效果及对PaO2、PaCO2的影响。方法:选取笔者所在医院收治的48例NRDS患儿,随机分为常规组(n=24)和试验组(n=24)。常规组给予无创持续气道正压通气治疗,试验组给予无创高频振荡通气治疗。对比两组PaO2、PaCO2、并发症发生率与撤机成功率;对比两组总机械通气时间、无创呼吸支持时间及住院时间。结果:治疗后6~72 h两组PaO2随时间延长均呈上升趋势,PaCO2呈下降趋势,且试验组PaO2高于常规组,PaCO2低于常规组(P<0.05);治疗后试验组与常规组并发症发生率分别为12.50%、20.83%,差异无统计学意义(P>0.05),但试验组撤机成功率为91.67%,明显高于常规组的62.50%(P<0.05);试验组总机械通气时间、无创呼吸支持时间及住院时间均短于常规组(P<0.05)。结论:无创高频振荡通气可有效缓解NRDS患儿临床症状,改善其PaO2、PaCO2值,提高撤机成功率,减轻患儿痛苦,促进患儿康复,提高患儿生存质量,值得临床推广应用。

Objective:To investigate the clinical effect of noninvasive high frequency oscillatory ventilation on neonatal respiratory distress syndrome(NRDS)and its effect on PaO2 and PaCO2.Method:A total of 48 cases of NRDS in our hospital were randomly divided into the routine group(n=24)and the experimental group(n=24).The routine group was treated with noninvasive continuous positive airway pressure ventilation,while the experimental group was treated with noninvasive high frequency oscillatory ventilation.PaO2,PaCO2,complication rate and weaning success rate were compared between the two groups,and total mechanical ventilation time,noninvasive respiratory support time and hospitalization time were compared between the two groups.Result:At 6-72 h after treatment,both groups showed an increasing trend of PaO2 and a decreasing trend of PaCO2,and the experimental group showed a higher trend of PaO2 than the conventional group and a lower trend of PaCO2 than the conventional group(P<0.05).After treatment,the incidence of complications in the experimental group and the conventional group was 12.50%and 20.83%,respectively,there was no significant difference(P>0.05),but the success rate of aircraft withdrawal in the experimental group was 91.67%,which was significantly higher than 62.50%in the conventional group(P<0.05).The duration of total mechanical ventilation time,noninvasive ventilation and hospitalization in the experimental group were shorter than those in the conventional group(P<0.05).Conclusion:Noninvasive highfrequency oscillatory ventilation can effectively alleviate the clinical symptoms of NRDS children,improve their PaO2 and PaCO2 values,improve the success rate of weaning,reduce the pain of children,promote the rehabilitation of children,and improve the quality of life of children,which is worthy of clinical application.