高频振荡通气联合PS气管内注入治疗未成熟儿严重低氧性呼吸衰竭的临床研究

High Frequency Oscillatory Ventilation Combined with PS Intratracheal Injection in the Treatment of Severe Hypoxic Respiratory Failure in Immature Children

目的:探讨高频振荡通气(HFOV)联合肺表面活性物质(PS)气管内注入治疗未成熟儿严重低氧性呼吸衰竭的效果。方法:回顾性分析2017年3月-2019年8月于本院就诊的56例未成熟儿严重低氧性呼吸衰竭患儿的临床资料,依据治疗方案不同将其分为对照组与治疗组,各28例。对照组进行常规治疗+HFOV,治疗组进行常规治疗+HFOV+PS气管内注入。比较两组治疗前后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、血氧饱和度(SaO2)、氧合指数(OI)、撤机时间、用氧时间、死亡及并发症发生情况。结果:治疗后,两组PaO2与SaO2均高于治疗前,而PaCO2与OI均低于治疗前(P<0.05)。治疗后,治疗组PaO2与SaO2均高于对照组,而PaCO2与OI均低于对照组(P<0.05)。治疗组撤机时间和用氧时间均短于对照组(P<0.05)。治疗组并发症发生率低于对照组(P<0.05)。两组死亡率比较,差异无统计学意义(P>0.05)。结论:采用HFOV联合PS气管内注入治疗未成熟儿严重低氧性呼吸衰竭的效果较好,可有效改善患儿病情,利于预后。

Objective:To investigate the effect of high frequency oscillation ventilation(HFOV)combined with pulmonary surfactant(PS)intratracheal injection in the treatment of severe hypoxic respiratory failure in immature children.Method:The clinical data of 56 immature children with severe hypoxic respiratory failure treated in our hospital from March 2017 to August 2019 were retrospectively analyzed.They were divided into control group and treatment group according to different treatment plans,28 cases in each group.The control group was treated with conventional treatment+HFOV.And the treatment group was treated with conventional treatment+HFOV+PS intratracheal injection.PaO2,PaCO2,SaO2,oxygenation index(OI),withdrawal time,oxygen use time,death and complications were compared between the two groups before and after treatment.Result:After treatment,PaO2 and SaO2 in the two groups were higher than those before treatment,while PaCO2 and OI were lower than those before treatment(P<0.05).After treatment,both PaO2 and SaO2 in the treatment group were higher than those in the control group,while both PaCO2 and OI were lower than those in the control group(P<0.05).The withdrawal time and oxygen use time of the treatment group were lower than those of the control group(P<0.05).The complication rate of the treatment group was lower than that of the control group(P<0.05).There was no significant difference in mortality between the two groups(P>0.05).Conclusion:HFOV combined with PS intratracheal injection has a better effect in the treatment of severe hypoxic respiratory failure in immature children,which can effectively improve the condition of the children and benefit the prognosis.