高频震荡通气治疗新生儿支气管肺发育不良的效果及对肺功能、血气分析的影响

Effect of High Frequency Oscillation Ventilation in Neonates with Bronchopulmonary Dysplasia and Influence for Pulmonary Function and Blood Gas Analysis

目的:探究高频震荡通气治疗新生儿支气管肺发育不良的效果,以及对肺功能、血气分析的影响。方法:选择2020年6月—2023年3月大连市妇女儿童医疗中心(集团)春柳院区收治的97例支气管肺发育不良新生儿,根据随机数字表法分为对照组(n=48)和观察组(n=49)。对照组进行常规机械通气,观察组则进行高频震荡通气。比较两组的总有效率、吸氧时间、机械通气时间、并发症总发生率、治疗前后的肺功能指标[25%潮气容积时的呼气流量(TEF25)、50%潮气容积时的呼气流量(TEF50)、达峰时间比(TPTEF/TE)及达峰容积比(VPEF/VE)]及血气分析结果[动脉血氧分压(PaO_(2))及动脉血二氧化碳分压(PaCO_(2))]。结果:观察组总有效率显著高于对照组,吸氧时间及机械通气时间均短于对照组,并发症总发生率显著低于对照组(P<0.05)。治疗前,两组TEF25、TEF50、TPTEF/TE、VPEF/VE、PaO_(2)、PaCO_(2)比较,差异均无统计学意义(P>0.05);治疗2、7 d后,两组TEF25、TEF50、TPTEF/TE、VPEF/VE、PaO_(2)均高于治疗前,PaCO_(2)均低于治疗前,且观察组TEF25、TEF50、TPTEF/TE、VPEF/VE、PaO_(2)均高于对照组,PaCO_(2)均显著低于对照组(P<0.05)。结论:高频震荡通气在新生儿支气管肺发育不良中的应用效果较好,可显著改善患儿的肺功能及血气分析状态,在新生儿支气管发育不良中的应用价值较高。

Objective:To explore the effect of high frequency oscillation ventilation on neonates with bronchopulmonary dysplasia and its influence on pulmonary function and blood gas analysis.Method:A total of 97 neonates with bronchopulmonary dysplasia admitted to Dalian Women and Children's Medical Center(Group)Chunliu Branch from June 2020 to March 2023 were selected and divided into control group(n=48)and observation group(n=49)according to random number table method.The control group received routine mechanical ventilation,and the observation group received high frequency oscillation ventilation.The total effective rate,oxygen duration,mechanical ventilation duration,total complication rate,pulmonary function indexes[expiratory flow at 25%moisture volume(TEF25),expiratory flow at 50%moisture volume(TEF50),ratio of time to peak tidal expiratory flow to total expiratory time(TPTEF/TE)and ratio of volume at peak tidal expiratory flow to expiratory tidal volume(VPEF/VE)]and blood gas analysis[partial arterial oxygen pressure(PaO_(2))and partial arterial carbon dioxide pressure(PaCO_(2))]before and after treatment were compared between the two groups.Result:The total effective rate of observation group was significantly higher than that of control group,oxygen inhalation time and mechanical ventilation time were shorter than those of control group,and the total incidence of complications was significantly lower than that of control group(P<0.05).Before treatment,there were no significant differences in TEF25,TEF50,TPTEF/TE,VPEF/VE,PaO_(2) and PaCO_(2) between the two groups(P>0.05).After 2,7 d of treatment,levels of TEF25,TEF50,TPTEF/TE,VPEF/VE and PaO_(2) in both groups were higher than those before treatment,and levels of PaCO_(2) were lower than those before treatment,and levels of TEF25,TEF50,TPTEF/TE,VPEF/VE and PaO_(2) in the observation group were higher than those in the control group,levels of PaCO_(2) were significantly lower than those of control group(P<0.05).Conclusion:The application of high frequency oscillation ventilation in neonates with bronchopulmonary dysplasia has good effect,can significantly improve the pulmonary function and blood gas analysis status of children,and has high application value in neonates with bronchopulmonary dysplasia.