高频振荡呼吸机治疗呼吸窘迫综合征致呼吸机相关性肺损伤的疗效观察  

Effect of High Frequency Oscillatory Ventilation in the Treatment of Ventilator-Associated Lung Injury Induced by Neonatal Respiratory Distress Syndrome

作　　者：魏兵[1] 何琳莉[2] 石伟[3] 刘国群[1] 谢驰[1] 

机构地区：[1]崇州市妇幼保健院儿科,四川成都611230 [2]重庆医科大学附属儿童医院呼吸科,重庆400013 [3]四川省人民医院儿科,四川成都610072

出　　处：《现代生物医学进展》2015年第17期3301-3303,3336,共4页Progress in Modern Biomedicine

摘　　要：目的：观察高频振荡呼吸机在治疗呼吸窘迫综合征（NRDS）致呼吸机相关性肺损伤（VALI）患儿的临床疗效。方法：选择我院2012年6月-2014年10月收治的NRDS致VALI患儿83例为研究对象,采用随机数字表法将患者随机分为研究组（45例）和对照组（38例）。两组均进行一般治疗,在此基础上对照组采用常规机械通气,研究组采用高频振荡呼吸机行高频通气。观察两组患者治疗24 h后p H值、二氧化碳分压（Pa CO2）、氧分压（Pa O2）、血压（BP）、心率（HR）及并发症情况。结果：两组患者治疗24 h后p H值、Pa CO2、Pa O2及BP比较,差异均无统计学意义（P〉0.05）,研究组HR心率低于对照组,差异存在统计学意义（P〈0.05）;研究组纵膈气肿、肺损伤、间质气肿及气胸的发生率均低于对照组,差异有统计学意义（P〈0.05）。结论：高频振荡呼吸机治疗NRDS致VALI患儿能够明显改善其症状及减少并发症的发生率,是治疗NRDS致VALI的有效的方式。Objective： To explore the clinical effect of high frequency oscillatory ventilation in the treatment of newborn with ventilator-associated lung injury（VALI） induced by neonatal respiratory distress syndrome（NRDS）. Methods： 83 cases of newborn with VALI induced by NRDS who were treated in our hospital from June 2012 to October 2014 were selected as research objective, they were divided into research group（43 newborns） and control group（38 newborns） according to the random number table method. Firstly, two groups were treated with routine therapy, then the control group was underwent conventional mechanical ventilation, while the research group was underwent high frequency oscillatory ventilation. Observed p H, Pa CO2, Pa O2 BP value and the incidence of complication between the two groups 24 h after treatment. Results： p H, Pa CO2, Pa O2 and BP value had no significant difference between two groups（P〉0.05）, but the HR value in research group was significant lower than control group（P〈0.05）; The incidence of mediastinal emphysema, lung injury, interstitial emphysema and pneumothorax in research group were significant lower than control group（P〈0.05）.Conclusion： High frequency oscillatory ventilation in the treatment of newborn with VALI induced by NRDS can significantly improve the symptom and reduce the incidence of complication, which is an effective treatment.

关 键 词：高频振荡呼吸机 呼吸窘迫综合征 呼吸机相关性肺损伤 新生儿 

分 类 号：R725.6[医药卫生—儿科]