不同频率振荡通气对胎粪吸入综合征患儿动脉血气指标的影响

Effects of different frequency oscillatory ventilation on arterial blood gas indexes in children with meconium aspiration syndrome

目的探讨不同频率振荡通气对胎粪吸入综合征患儿动脉血气指标的影响。方法选取2018年1月至2020年6月本院新生儿重症监护病房收治的80例胎粪吸入综合征患儿作为研究对象,采用随机数字表法分为常频组和高频组,每组40例。常频组应用常频振荡通气进行治疗,高频组应用高频振荡通气进行治疗,比较两组通气前及通气后12、24 h动脉血气指标(pH、动脉血氧分压、动脉血二氧化碳分压)及血流动力学指标(心率、搏动指数、射血分数、每搏量)。结果通气前,两组pH、动脉血氧分压、动脉血二氧化碳分压比较差异无统计学意义;两组通气前与通气后12、24 h的pH比较差异均无统计学意义;通气后12、24 h,观察组动脉血氧分压均高于同一时间点对照组,动脉血二氧化碳分压均低于同一时间点对照组,差异有统计学意义(P<0.05)。通气前及通气后12、24 h,两组组内及组间心率、搏动指数、射血分数、每搏量比较差异均无统计学意义。结论与常频机械通气比较,高频振荡机械通气对胎粪吸入综合征患儿的干预效果更好,可改善动脉血气指标,值得临床推广应用。

Objective To investigate the effects of different frequencies oscillating ventilation on arterial blood gas indexes in children with meconium aspiration syndrome.Methods A total of 80 cases of children with meconium aspiration syndrome who were admitted to Neonatal Intensive Care Unit of our hospital from January 2018 to June 2020 were selected as the study subjects,and they were divided into normal frequency group and high frequency group according to random number table method,with 40 cases in each group.The normal frequency group was treated with normal frequency oscillation ventilation,and the high frequency group was treated with high frequency oscillation ventilation,the arterial blood gas indexes(pH,arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide)and hemodynamic indexes(heart rate,pulse index,ejection fraction,stroke volume)before and after ventilation at 12 and 24 h between the two groups were compared.Results Before ventilation,there were no significant differences in pH,arterial partial pressure of oxygen and arterial partial pressure of carbon dioxide between the two groups;there was no significant difference in pH between the two groups before and after ventilation at 12 and 24 h;at 12 and 24 h after ventilation,the arterial partial pressure of oxygen in the observation group was higher than that in the control group at the same time point,and the arterial partial pressure of carbon dioxide was lower than that in the control group at the same time point,and the difference was statistically significant(P<0.05).Before ventilation and at 12 and 24 h after ventilation,there were no significant differences in heart rate,pulse index,ejection fraction and stroke volume within or between the two groups.Conclusion Compared with normal frequency oscillation ventilation,high frequency oscillatory mechanical ventilation has better intervention effect on meconium aspiration syndrome,it can improve arterial blood gas index and is worthy of clinical application.