吸入一氧化氮联合高频震荡通气治疗新生儿严重呼吸衰竭的临床效果

Clinical effect of inhaled nitric oxide combined with high frequency oscillatory ventilation in the treatment of neonatal severe respiratory failure

目的探究吸入一氧化氮(iNO)联合高频震荡通气(HFOV)治疗新生儿严重呼吸衰竭的临床效果。方法选取2012年5月至2019年10月在本院进行治疗的200例严重呼吸衰竭新生儿为研究对象,按照治疗方式不同将其分为观察组(iNO联合HFOV治疗)和对照组(HFOV治疗),各100例。比较两组的动脉血气指标(pH、PaO2、PaCO2)、机械通气时间、总氧疗时间、呼吸功能指标(OI和PaO2/FiO2)、预后情况及治疗效果。结果治疗2、24 h,观察组pH、PaCO2均低于对照组、PaO2高于对照组,差异具有统计学意义(P<0.05)。观察组的机械通气时间及总氧疗时间均短于对照组(P<0.05)。治疗后24 h,观察组OI低于对照组,PaO2/FiO2高于对照组,差异具有统计学意义(P<0.05)。观察组的肺出血、肺气肿、治疗后1个月内死亡的患儿占比均低于对照组(P<0.05)。观察组的治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。结论iNO联合HFOV治疗新生儿严重呼吸衰竭,能显著改善动脉血气指标、呼吸功能指标、预后情况,缩短机械通气时间、总氧疗时间,提高治疗效果,值得在临床中推广应用。

Objective To investigate the clinical effect of inhaled nitric oxide(iNO)combined with high frequency oscillatory ventilation(HFOV)in the treatment of neonatal severe respiratory failure.Methods A total of 200 newborns with severe respiratory failure treated in our hospital from May 2012 to October 2019 were selected as the research objects.According to different treatment methods,the newborns were divided into observation group(iNO combined with HFOV treatment)and control group(HFOV treatment),with 100 cases in each group.Arterial blood gas indexes(pH,PaO2,PaCO2),mechanical ventilation time,total oxygen therapy time,respiratory function indexes(OI and PaO2/FiO2),prognosis and treatment effect were compared between the two groups.Results At 2 and 24 h of treatment,the pH and PaCO2 of the observation group were lower than those of the control group,and the PaO2 was higher than that of the control group,the differences were statistically significant(P<0.05).The mechanical ventilation time and total oxygen therapy time of the observation group were shorter than those of the control group(P<0.05).At 24 h after treatment,OI in the observation group was lower than that in the control group,and PaO2/FiO2 was higher than that in the control group,the differences were statistically significant(P<0.05).The proportions of newborns with pulmonary hemorrhage,emphysema and death within 1 month after treatment in the observation group were lower than those in the control group(P<0.05).The total effective rate of treatment of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion The iNO combined with HFOV in the treatment of neonatal severe respiratory failure can significantly improve the arterial blood gas indexes,respiratory function indexes,prognosis,shorten the time of mechanical ventilation and total oxygen therapy,and improve the therapeutic effect,which is worthy of clinical promotion and application.