高频振荡通气治疗新生儿呼吸窘迫综合征的疗效评价  

The Curative Effect Evaluation of High Frequency Oscillatory Ventilation in Neonatal Respiratory Distress Syndrome

作　　者：李忠良[1] 刘玉娟[2] 王守叶[1] 高桂香[3] 

机构地区：[1]潍坊市妇幼保健院新生儿科,山东潍坊261011 [2]潍坊市妇幼保健院供应科 [3]潍坊市妇幼保健院儿童保健科

出　　处：《潍坊医学院学报》2015年第2期87-90,共4页Acta Academiae Medicinae Weifang

摘　　要：目的：评价高频振荡通气对新生儿呼吸窘迫综合征治疗的有效性及安全性。方法对2010年1月～2013年12月我院NICU收治的61例新生儿呼吸窘迫综合征患儿进行回顾性分析，按机械通气方式分为高频振荡通气组（ HFOV组）及常频机械通气组（ CMV组），对两组患儿一般情况、临床治疗及疗效评价相关数据进行统计学分析。结果高频振荡机械通气前、后血气变化显示机械通气后动脉血二氧化碳分压（ PaCO2）、吸入氧浓度（ FiO2）、氧合指数（ OI）较机械通气前下降；动脉血氧分压（ PaO2）、动脉／肺泡氧分压（ a／APO2）较机械通气前升高；机械通气后HFOV组与CMV组动脉血二氧化碳分压（PaCO2）、吸入氧浓度（FiO2）、氧合指数（OI）、动脉血氧分压（PaO2）、动脉／肺泡氧分压（a／APO2）相比较，差异有统计学意义（P＜0．05）。 HFOV组支气管肺发育不良（BPD）、肺气漏并发症低于CMV组，差异有统计学意义（P＜0．05），颅内出血发生率差异无统计学意义（P＞0．05）。存活患儿的使用呼吸机时间、氧疗时间、住院时间HFOV组比CMV组为短，差异有统计学意义（P＜0．01）。结论高频振荡通气治疗新生儿呼吸窘迫综合征疗效肯定，HFOV组能更快、更好地改善NRDS患儿的肺氧合功能，通气效果、病程及并发症发生率等明显优于CMV组，同时没有增加颅内出血危险，早期应用于NRDS治疗具有很好的疗效。Objective To evaluate the effects and security of high frequency oscillatory ventilation on neonatal respiratory dis -tress syndrome.Methods A total of 61 infants with neonatal respiratory distress syndrome from January 2010 to December 2013 in our NICU accorded with the inclusion criteria were selected and divided into two groups by the mechanical ventilation ,the high frequency oscillatory ventilation group（HFOV） and the conventional mechanical ventilation group （CMV）.A statistical analysis on the general situation ,clinical treatment and curative effect evaluation of the two groups was performed .Results The arterial carbon dioxide tension （ PaCO2 ） ,fraction of in-spired oxygen（FiO2） and oxygenation index （OI） after high frequency oscillatory ventilation were declined before that ,however the arterial oxygen tension （ PaO2 ） and arterial-alveolar oxygen ratio （ a/APO2 ） were rised before high frequency oscillatory ventilation .Compared to the arterial carbon dioxide tension （ PaCO2 ） ,fraction of inspired oxygen （ FiO2 ） ,oxygenation index （ OI） ,arterial oxygen tension （ PaO2 ） and arte-rial-alveolar oxygen ratio（a/APO2） of the CMV groups after mechanical ventilation ,those of HFOV groups were statistically different（P〈0. 05）.The occurance of bronchopulmonary dysplasia （BPD） and pulmonary air-leak in HFOV groups was lower than that in CMV groups （P〈0.05）,but the incidence of intracranial hemorrhage （ICH） was no statistically significant difference .The length of mechanical ventilation ,ox-ygen therapy and hospital stays of survival in HFOV groups were shorter than that in the CMV groups （P〈0.01）.Conclusion There is nodoubt that the high frequency oscillatory ventilation can be used in the treatment of neonatal respiratory distress syndrome .The HFOV groups can improve the pulmonary oxygenation function with NRDS faster and better .Their ventilation effect ,duration and the incidence of complica-tions and so on are obviously better than

关 键 词：高频振荡通气 新生儿 呼吸窘迫综合征 疗效 

分 类 号：R725.6[医药卫生—儿科]