高频震荡通气在新生儿呼吸窘迫综合征中应用  

Application of high frequency oscillatory ventilation in the neonatal respiratory distress syndrome

作　　者：刘宝俊[1] 王宏伟[2] 薛爱梅 左晓晓 王琳[3] 

机构地区：[1]黄河三门峡医院新生儿/儿科监护病房,河南三门峡472000 [2]黄河三门峡医院内科,河南三门峡472000 [3]黄河三门峡医院第二门诊,河南三门峡472000

出　　处：《中华实用诊断与治疗杂志》2016年第2期177-179,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨高频震荡通气(high frequency oscillatory ventilation,HFOV)在治疗合并气漏的新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)中应用价值。方法 40例合并气漏的NRDS患儿,25例经HFOV治疗者为HFOV组,15例行常频通气(conventional mechanical ventilation,CMV)治疗者为CMV组。比较治疗前、后2组pa(O_2)、pa(CO_2)、吸入氧浓度(fraction of inspired oxygen,FiO_2)、氧合指数(oxygenation index,OI)的变化,比较2组机械通气时间、闭式胸膜腔引流时间、住院时间及疗效。结果辅助机械通气8h,HFOV组pa(O_2)[(10.0±1.2)kPa]高于CMV组[(9.1±0.9)kPa](P<0.05),OI[(13.8±1.9)kPa]、pa(CO_2)[(5.8±0.9)kPa]、FiO_2[(72.0±5.0)%]低于CMV组[(14.3±1.8)kPa、(6.0±0.4)kPa、(80.0±5.0)%](P<0.05),24、48h时以上指标继续好转,2组比较差异有统计学意义(P<0.05);HFOV组通气时间[(5.90±0.58)d]、闭式胸膜腔引流时间[(6.97±0.34)d]、住院时间[(12.08±0.99)d]低于CMV组[(7.24±0.71)、(8.10±0.56)、(15.20±1.26)d](P<0.05),治愈率(92%)与CMV组(80%)比较差异无统计学意义(P>0.05)。结论与CMV相比,应用HFOV治疗合并气漏的NRDS更具优势,可作为临床治疗首选通气模式。Objective To explore the value of high frequency oscillatory ventilation （HFOV） to the treatment of neonatal respiratory distress syndrome （NRDS） in patients with lung air leak. Methods In 40 neonates with NRDS and lung air leak, 25 patients received HFOV （HFOV group） and 15 received conventional mechanical ventilation （CMV group）. The levels of pa（Oz ）, pa（CO2 ）, fraction of inspired oxygen （FiO2） and oxygenation index （OI） were observed and compared between two groups before and after treatment, meanwhile the mechanical ventilation time, pleural cavity closed drainage time, hospitalization stay and clinical effects were compared between two groups. Results After 8 hours, the pa（O2 ） was significantly higher in HFOV group （（10.0±1.2） kPa） than that in CMV group （（9. 1±0. 9） kPa） （P〈0.05）. OI （（13.8±1.9） kPa）, pa（CO2） （（5.8±0.9） kPa） and FiO2 （（72.0±5.0）%） in HFOV group were significantly lower than those in CMV group （（14.3±1.8） kPa, （6.0±0.4） kPa, （80.0±5.0）%） （P〈0.05）. The results continued to improve in 24 and 48 hours and remained significant differences between two groups. The mechanical ventilation time （（5.90±0.58） d）, pleural cavity closed drainage time （（6.97±0.34） d）, hospitalization stay （（12.08±0.99） d） in HFOV group were significantly shorter than those in CMV group （（7.24±0.71）, （8.1±0.56）, （15.2±1.26） d） （P〈 0.05）. There was no significant difference in the effective rate between HFOV group （92%） and CMV group （80%） （P〉0.05）. Conclusion HFOV is superior to CMV for NRDS in patients with lung air leak, and can be selected as the first clinical choice.

关 键 词：新生儿呼吸窘迫综合征 气漏 高频震荡通气 

分 类 号：R722.1[医药卫生—儿科]