高频震荡通气治疗新生儿气胸的临床研究  

Clinical study of high frequency oscillatory ventilation for the treatment of neonatal pneumothorax

作　　者：朱筱珊[1] 刘光辉[1] 戴立英[1] 

机构地区：[1]安徽省立儿童医院新生儿科,合肥230022

出　　处：《安徽医学》2013年第6期742-744,共3页Anhui Medical Journal

摘　　要：目的观察高频震荡通气(HFOV)在新生儿气胸中的疗效。方法回顾分析2010年5月至2012年11月接受HFOV治疗的17例气胸新生儿患者的临床资料,比较患者接受HFOV治疗前及上机后2、12、24和48 h的二氧化碳分压(PaCO2)、血氧分压(PaO2)、血氧指数(OI)及吸入氧浓度(FiO2)变化。结果 17例患者15例治愈,2例放弃治疗。治愈患者在上机后2 h观察到PaCO2由(11.2±0.85)kPa下降至(6.20±0.73)kPa(P<0.05),而PaO2进行性上升,由治疗前的(4.80±0.47)kPa至治疗后12 h升高至(7.83±0.56)kPa(P<0.05),这一变化在24 h开始最为明显,与上机前差异有统计学意义(P<0.01)。2例患者出现呼吸机相关性肺炎,抗炎治疗后好转。结论 HFOV能改善新生儿气胸患者的氧合功能,安全性好,是有效的机械通气方法。Objective To evaluate the clinical effect of high frequency oscillatory ventilation for the treatment of neonatal pneumotho- tax. Methods Neonates diagnosed with neonatal pneumothorax and received HFOV between May 2010 and November 2012 were enrolled in this retrospective study. Results Ahogether 17 patients were received HFOV treatments at a mean age （13.55±1.7） h. The mean duration of ItFOV was （55.1±15）h. Fifteen patients were cured after HFOV treatments. PaCO2 was significantly improved fi＇om （11.2±0.85）kPa to （6.20± 0.73）kPa 2 hours after HFOV and the PaO2 increased gradually from （4.80±0.47）kPa to （7.83±0.56）kPa 12 hours later（P 〈0.05）. Two cases were given up. The main complication was ventilator-associated pneumonia which was cured by anti-biotics treatment. Conclusion HFOV may improve PaCO2 and PaO2 /FiO2 in neonatal pneumothorax with acute respiratory failure and is a sate, efi^ctive method of met：hanieal ventilation.

关 键 词：高频震荡通气 新生儿 气胸 

分 类 号：R722.1[医药卫生—儿科]