高频呼吸机辅助治疗高原地区新生儿肺出血的疗效观察

Clinical efficacy observation of high frequency ventilator assisting the treatment of neonatal pulmonary hemorrhage in plateau area

目的探讨高频呼吸机辅助治疗高原地区新生儿肺出血的临床疗效及降低新生儿病死率的应用价值。方法回顾性选取2016年1月至2020年12月于康定市甘孜州人民医院接受治疗的肺出血新生儿100例,依据治疗方式的不同分为对照组(机械通气辅助治疗,n=50)、观察组(高频呼吸机辅助治疗,n=50),比较2种辅助治疗方法的疗效。治疗前后检测2组患儿血浆D-二聚体、纤维蛋白降解产物水平的变化以及治疗后并发症及病死率。结果观察组患儿治疗有效率明显高于对照组;观察组患儿治疗后D-二聚体、纤维蛋白降解产物低于对照组;观察组患儿肺出血停止时间及使用呼吸机时间短于对照组;观察组患儿并发症发生率及病死率低于对照组;以上结果差异均有统计学意义(P<0.05)。结论高频呼吸机辅助治疗高原地区新生儿肺出血,可有效增加患儿的凝血指标表达水平,并减少呼吸机的使用天数,患儿止血效果明显,术后并发症及病死率降低,值得临床进一步研究。

Objective To investigate the clinical effect of high frequency ventilator assisting the treatment of neonatal pulmonary hemorrhage in plateau area and the application value of reducing neonatal mortality.Methods A total of 100 cases of neonatal pulmonary hemorrhage treated in Kangding City Ganzi Tibetan Autonomous Prefecture People’s Hospital from January 2016 to December 2020 were retrospectively selected.According to different treatment methods,they were divided into control group(treated with mechanical ventilation,n=50)and observation group(treated with high-frequency ventilator assistance,n=50).The plasma D-dimer(DD)and fibrinogen degradation products changes before and after treatment were detected,and the incidence of complication and mortality rate after treatment were analyzed.Results The therapeutic effectiveness in the observation group was significantly higher than that in the control group;the DD and fibrinogen degradation products after treatment in the observation group were lower than those in the control group;the pulmonary hemorrhage cessation time and the ventilator using period in the observation group were shorter than those in the control group;the incidence of complication and the mortality rate in the observation group were lower than those in the control group;the differences of the above results were statistically significant(P<0.05).Conclusion The high frequency ventilator assisted treatment of neonatal pulmonary hemorrhage in plateau area can significantly increase the expression levels of coagulation indexes with obvious hemostatic effect,reduce the days of ventilator use,postoperative complications,and lower mortality rate,which is worthy of further clinical study.