HFOV治疗新生儿严重肺疾病合并呼吸衰竭的临床观察  

The Clinical Observation of High Frequency Oscillatory Ventilation in the Treatment of Neonatal Severe Lung Disease Complicated With Respiratory Failure

作　　者：吴州丽[1] 谭宁[1] 朱文军[1] 

机构地区：[1]郴州市第一人民医院北院新生儿科,湖南郴州423000

出　　处：《中南医学科学杂志》2012年第4期376-380,共5页Medical Science Journal of Central South China

摘　　要：目的回顾性观察比较高频振荡通气(HFOV)和常频通气治疗新生儿严重肺疾病合并呼吸衰竭的有效性及安全性。方法 HFOV组79例,常频组80例,观察对比两组治疗前后氧合参数、呼吸机参数、治愈率、上机天数、住院天数以及并发症等的差异。结果 HFOV组治疗6 h后通气氧合情况明显好转,氧指数(OI)下降至8.82±3.98(P<0.05),动脉血氧分压(PaO_2)升高至73.88±17.03 mmHg(P<0.05),二氧化碳分压(PaCO_2)下降至38.51±5.03 mmHg(P<0.05),治疗24 h后氧浓度(FIO_2)、OI明显降低,上机天数缩短,并发支气管肺发育不良(BPD)及气漏减少,与常频组比较差异有统计学意义(P<0.05)。结论 HFOV治疗新生儿严重肺疾病合并呼吸衰竭氧合改善更快,短时间内氧浓度及OI下降更快,上机天数缩短,并发BPD、气漏减少,临床疗效满意。Objective To contrast the validity and security of treating neonates severe lung disease complicated with respiratory failure,between high frequency oscillatory ventilation （HFOV） and conventional mechanical ventilation（CMV）. Methods 79 patients were treated by HFOV ,80 patients were treated by conventional mechanical ventilation （CMV） ,there were differences in the oxygenate parameter, respiratory parameter, the cure rate, ventilator support days, length of stay, complications and so on between two groups,which were observed before and after treatment. Results In HFOV group,after 6h treatment ventilation oxygenation improved obviously, oxygen index （OI） dropped to 8.82 ±3.98 （ P 〈 0.05 ）, PaO2 rose to 73. 88 ± 17.03 mmHg（ P 〈 0.05 ） and PaCO2 dropped to 38.51 ±5.03 mmHg（ P 〈0.05 ）. After 24 h treatment FiO2 and OI reduced significantly, ventilator support days shortened, concurrent BPD and gas leak decreased ,there were statistical differences between CMV group and HFOV group（ P 〈 0. 05）. Conclusion HFOV treatment in neonates severe lung disease complicated with respiratory failure could improve oxygenation faster, drop oxygen concentration and O more faster in short time, shorten ventilator support days,reduce concurrent BPD and gas leak,and the clinical effect is satisfactory.

关 键 词：高频振荡通气 常频通气 新生儿 严重肺疾病 呼吸衰竭 

分 类 号：R722.135[医药卫生—儿科]