高频振荡通气在新生儿呼吸窘迫综合征中的临床应用  

作　　者：何中倩[1] 李晓东[1] 田青[1] 张升荣[1] 陈宏洁 

机构地区：[1]广东医学院附属深圳南山医院,518052

出　　处：《浙江临床医学》2014年第11期1725-1727,共3页Zhejiang Clinical Medical Journal

摘　　要：目的：探讨高频振荡通气（HFOV）作为新生儿呼吸窘迫综合征（RDS）初始治疗的疗效及安全性。方法回顾性分析2010年1月至2013年6月住院治疗、需机械通气的RDS患儿50例，2011年11月前以常频机械通气的25例患儿作为CMV组，2011年11月后以高频振荡通气的25例患者患者作为HFOV组。结果机械通气1h后，两组患儿吸入氧浓度（FiO2）、平均气道压（MAP）、动脉血二氧化碳分压（PCO2）动脉血氧分压（PO2）均较0h有不同程度改善，且在1h及6hHFOV组较CMV组改善更明显，差异有统计学意义（P〈0.05）；机械通气24h后HFOV组的PO2、MAP与CMV组比较，差异无统计学意义（P〉0.05），PCO2差异有统计学意义（P〈0.05）。HFOV组患儿用氧时间与CMV组比较差异有统计学意义（P〉0.05）。两组气漏、颅内出血、心力衰竭、DIC发生率差异无统计学意义（P〉0.05）。两组患者休克发生率差异有统计学意义（P〈0.05）。HFOV发生休克症状的病人增多，但积极处理后可以缓解。结论 HFOV能更好更快的改善RDS患儿的氧合功能，缩短用氧时间，但24h后的疗效与CMV组比较无差别，未缩短使用呼吸机的时间。未明显增加并发症的发生，休克积极处理后可以纠正。HFOV可以作为治疗新生儿呼吸窘迫综合征的又一选择。Objective To investigate efficacy and safety of high frequency oscillatory ventilation（HFOV） for neonatal respiratory distress syndrome（ RDS）. Methods A retrospective analysis is studied in 50 cases of newborns who need mechanical ventilation of RDS from January 2010 to June 2013 in our hospital. The infants who were born after November 2011 were research group（HFOV,25 cases）. The infants who were born before November 2011 were control group（CMV,25cases）. Results One hour after giving mechanical ventilation,there was an increase in the PO2,and decrease in PCO2,FiO2,MAP in both groups. There was more significant difference in these dates at one hour and six hour after giving mechanical ventilation in HFOV group（P〈0.05）.There was no difference in PO2、MAP and there was difference in PCO2（P〈0.05）between two groups at 24 hour.But there was difference in high oxygen concentration exposure time between HFOV group and CMV group.（P〉0.05）. No significant differences were found in air leak,intracranial hemorrhage,heart failure,DIC between two groups（P〉0.05）. There was statistically significant in shock between groups（P〈0.05）. There were more infants occurred shock in HFOV group,but after actively treatment,they improved soon. Conclusions HFOV has a better pulmomary oxygenation and decreased time of high oxygen concentration exposure. There was no difference in the curative effect compared with CMV group after 24 hours .HFOV could not shorten the time of the use of ventilation. HFOV did not significantly increase the occurrence of complications. There were more infants who got shock in HFOV group,but after actively treatment,they improved soon. HFOV can serve as an alternative for the treatment of neonatal respiratory distress syndrome.

关 键 词：高频振荡通气 常频通气 呼吸窘迫综合征 新生儿 

分 类 号：R722.12[医药卫生—儿科]