高频振荡通气治疗新生儿胎粪吸入综合征的效果观察

Observation on the efficacy of high frequency oscillatory ventilation in the treatment of neonatal meconium aspiration syndrome

目的探讨高频振荡通气治疗新生儿胎粪吸入综合征的效果。方法选取2020年7月至2021年8月莆田市儿童医院新生儿科收治的84例新生儿胎粪吸入综合征(MAS)患儿,对84例MAS患儿进行随机分组,观察组及对照组各42例,对照组行常频振荡通气(CMV)治疗,观察组行高频振荡通气(HFOV)治疗,对两组治疗后血气指标、氧合指数(OI)、吸入氧体积分数、氧疗时间、上机时间及住院时间进行比较。结果治疗前,两组pH、血氧分压(PO_(2))、血二氧化碳分压(PCO_(2))比较,差异无统计学意义(P>0.05),治疗后,观察组pH、PCO_(2)水平较对照组高,PO_(2)水平较对照组低,差异有统计学意义(P<0.05);治疗前,两组OI、吸入氧体积分数比较,差异无统计学意义(P>0.05),治疗后,观察组OI、吸入氧体积分数均低于对照组,差异有统计学意义(P<0.05);观察组氧疗、上机及住院时间均较对照组短,差异有统计学意义(P<0.05)。结论HFOV在新生儿胎粪吸入综合征中应用价值较高,可改善患儿动脉血气指标、OI,还可缩短上机与住院时间,值得推广应用。

Objective To investigate the efficacy of high frequency oscillatory ventilation in the treatment of neonatal meconium aspiration syndrome.Methods A total of 84 cases of neonatal meconium aspiration syndrome(MAS)admitted to the Department of Neonatology in the Children’s Hospital of Putian City from July 2020 to August 2021 were selected.They were randomly divided into the observation group(n=42)and the control group(n=42).The control group was treated with constant frequency mechanical ventilation(CMV),while the observation group was treated with high frequency oscillation ventilation(HFOV).After treatment,blood gas indices,oxygenation index(OI),inspired oxygen volume fraction,and the time of oxygen therapy,using ventilator and hospitalization were compared between the two groups.Results Before treatment,there were no statistically significant differences in pH,partial pressure of oxygen(PO_(2)),partial pressure of carbon dioxide(PCO_(2))between the two groups(P>0.05).After treatment,the pH and PCO_(2) level in the observation group were higher than those in the control group,while PO_(2) level was lower than that in the control group,with statistically significant differences(P<0.05).Before treatment,there were no statistically significant differences in OI and inspired oxygen volume fraction between the two groups(P>0.05).After treatment,the OI and inspired oxygen volume fraction in the observation group was lower than that in the control group,with statistically significant differences(P<0.05).The time of oxygen therapy,using ventilator and hospitalization in the observation group were all shorter than those in the control group,with statistically significant differences(P<0.05).Conclusion The application significance of HFOV in neonatal MAS is relatively high.It can improve arterial blood gas indices and OI of children,and shorten the time of using ventilator and hospitalization.Therefore,it is worthy of application.