辅助/控制通气和高频通气模式在新生儿呼吸衰竭有创机械通气救治中的应用比较

Comparison of the application of assist/control ventilation and high frequency ventilation in the treatment of neonatal respiratory failure with invasive mechanical ventilation

目的:探讨辅助/控制通气(assist/control ventilation,A/C ventilation)和高频通气(high frequency oscillatory ventilation,HFOV)模式有创机械通气救治新生儿呼吸衰竭的效果差异。方法:选取在蚌埠市第三人民医院接受有创机械通气救治的88例呼吸衰竭新生儿,按照简单随机分组方法均分为A/C组和HFOV组。记录并比较两组新生儿上机治疗前和治疗24 h、48 h血气分析指标,比较两组临床疗效和并发症发生情况。结果:两组治疗24 h、48 h后动脉二氧化碳分压(partial pressure of carbon dioxide,PaCO_(2))、氧合指数(oxygenation index,OI)、呼吸指数(respiratory index,RI)较治疗前下降,动脉氧分压(partial pressure of oxygen,PaO_(2))、动脉氧分压/吸氧浓度(partial pressure of oxygen/fraction of inspired oxygen,PaO_(2)/FiO_(2))升高,差异有统计学意义(P<0.05);HFOV组治疗24 h、48 h后上述血气分析指标改善均优于A/C组,差异有统计学意义(P<0.05);HFOV组临床总有效率(91.318%)高于A/C组(77.27%),总并发症(15.91%)低于A/C组(34.09%),差异有统计学意义(P<0.05)。结论:A/C和HFOV有创通气治疗均能有效改善新生儿呼吸衰竭的血气分析指标,但HFOV模式的临床疗效更佳,并发症发生率较低。

Objective:To investigate the differences in the effects of assist/control ventilation,A/C ventilation and high frequency ventilation(HFOV)in the treatment of neonatal respiratory failure.Methods:A total of 88 neonates with respiratory failure were randomly divided into A/C group and HFOV group,44 cases in each group.Record and compare the blood gas of the two groups before treatment and 24 h and 48 h after treatment.The clinical efficacy and complications of the two groups were compared.Results:Two groups treated 24 h,48 h after arterial partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(OI),respiratory index(RI)is lower than before treatment,partial pressure of oxygen,arterial oxygen partial pressure(PaO_(2)),partial pressure of oxygen/fraction of inspired oxygen(PaO_(2)/FiO_(2))elevated,difference was statistically significant(P<0.05).HFOV group had better blood gas analysis than A/C group after 24 h,48h treatment,difference was statistically significant(P<0.05).The total clinical efficiency of HFOV group was 91.318%higher than that of A/C group 77.27%,15.91%of total complications were lower than 34.09%in A/C group,difference was statistically significant(P<0.05).Conclusion:A/C and HFOV invasive ventilation can effectively improve the blood gas analysis index of neonatal respiratory failure,but HFOV mode has better clinical effect and lower complication rate.