高频振荡通气治疗在重症新生儿呼吸窘迫综合征的应用  

High frequency oscillatory ventilation in treatment of serious neonatal respiratory distress syndrome

作　　者：方瑞[1] 梁霞[1] 都鹏飞[1] 

机构地区：[1]安徽医科大学第二附属医院新生儿科,合肥230032

出　　处：《安徽医学》2014年第3期326-328,共3页Anhui Medical Journal

摘　　要：目的探讨高频振荡通气(HFOV)治疗重症新生儿呼吸窘迫综合征(RDS)的疗效及安全性。方法 18例重症RDS患儿在常频通气治疗过程中,出现以下情况采用HFOV治疗:吸入氧浓度≥0.8、平均气道压≥10 cmH2O持续4 h以上,经皮血氧饱和度(SpO2)仍不能稳定在85%以上者;X线胸片提示肺透明膜病变在Ⅲ级以上或合并有肺气漏、肺动脉高压者。结果经HFOV治疗后,18例患儿肤色渐转红,1.5 h内SpO2≥90%,12 h后患儿吸入氧浓度(FiO2)、氧合指数(OI)、平均气道压(MAP)、动脉血二氧化碳分压(PaCO2)与HFOV前比较改善明显,差异有统计学意义(P<0.05)。所有患儿均成功撤机并存活出院。总机械通气时间平均为95.8 h,其中HFOV时间平均为39.7 h。治疗过程中心率、血压无明显变化。结论 HFOV用于治疗重症RDS安全有效。Objective To evaluate the effectiveness and safety of high frequency oscillatory ventilation in the treatment of serious neonatal respiratory distress syndrome.Methods Eighteen cases of children with serious neonatal respiratory distress syndrome were treated by conventional mechanical ventilation（CMV）,and the following appeared in the process of using HFOV treatment：the inhaled oxygen con-centration was 0.8 or higher,mean airway pressure 10 or more cmH2 O lasted more than 4 hours,transcutaneous oxygen saturation was still not stable at 85% above;X-ray suggested pulmonary hyaline membrane disease above the level III or combined with pulmonary gas leakage,pul-monary hypertension.Results During 12 hours after initiating HFOV,the FiO2,oxygen index （OI）,mean airway pressure （MAP）and Pa CO2 reduced significantly.All children were successfully withdrawn machine and lived out of the hospital.Total mechanical ventilation time averaged 95.8 h,and HFOV time averaged 39.7 h.No significant cardiac complication was observed.Conclusion HFOV is safe and effec-tive in the treatment of serious neonatal respiratory distress syndrome.

关 键 词：呼吸窘迫综合征 高频通气 新生儿 

分 类 号：R722.1[医药卫生—儿科]