高频通气联合吸入一氧化氮治疗新生儿难治性呼吸衰竭疗效分析  

The efficacy of high frequency oscillatory ventilation combined with inhaled nitric oxide for treating refractory respiratory failure in neonates

作　　者：刘丽芳[1] 陈宏洁 李晓东[1] 田青[1] 张升荣[1] 

机构地区：[1]深圳市南山区人民医院新生儿科,518052

出　　处：《中国新生儿科杂志》2016年第6期442-445,共4页Chinese Journal of Neonatology

摘　　要：目的探讨高频振荡通气(HFOV)联合吸入一氧化氮(i NO)治疗新生儿难治性呼吸衰竭的临床疗效。方法选择我院出生并入住新生儿重症监护病房诊断为难治性呼吸衰竭的新生儿,随机分为观察组和对照组,观察组应用HFOV联合i NO治疗,对照组应用HFOV治疗。观察两组患儿治疗前及治疗后1、12、24、48 h血气、吸入氧浓度(FiO_2)等指标的变化及并发症发生情况。结果共纳入85例患儿,观察组44例,对照组41例。两组患儿性别、胎龄、出生体重、原发病等比较差异均无统计学意义(P>0.05)。治疗前两组PaO_2、PaCO_2、FiO_2差异均无统计学意义(P>0.05)。治疗后24 h观察组PaO_2高于对照组[(67.2±7.6)mm Hg比(47.1±5.2)mm Hg],PaCO_2和FiO_2低于对照组[(40.3±7.6)mm Hg比(57.1±5.4)mm Hg,(46±14)%比(55±13)%,P<0.05];治疗后48 h观察组PaO_2、PaCO_2、FiO_2亦均优于对照组,差异有统计学意义(P<0.05)。观察组呼吸机使用时间短于对照组,病死率低于对照组[(120.4±16.2)h比(148.9±19.3)h,6.8%比26.8%,P<0.05]。两组并发症发生率差异无统计学意义(P>0.05)。结论 HFOV联合i NO治疗新生儿难治性呼吸衰竭疗效显著,可显著改善氧合,提高患儿存活率。患儿短时间、低剂量i NO治疗未发生严重不良反应。Objective To study the clinical effect of high frequency oscillatory ventilation（ HFOV） in conjunction with inhaled nitric oxide（ i NO） in the treatment of neonatal refractory respiratory failure. Methods Neonates who were born in our Hospital and diagnosed as refractory respiratory failure in our neonatal intensive care unit were randomly assigned into the observation group and the control group. Neonates in the observation group were treated with HFOV ＋ i NO,and neonates in the control group were treated with HFOV. Blood gas analysis,inhaled oxygen concentration（ FiO2）and other indicators before treatment and 1,12,24 and 48 h after treatment were collected. The complications of two groups also were observed. Results There were 85 cases,44 in the observation group and 41 in the control group. There were no statistically significant differences between two groups in gender,gestational age,birth weight and the primary disease（ P〉0. 05）. No statistically significant differences were found between two groups in PaO2,PaCO2 and FiO2 before treatment（ P〈0. 05）. 24 h after treatment,PaO2 of the observation group was higher than that of the control group,PaCO2 and FiO2of the observation group were lower than that of the control group [（ 67. 2 ± 7. 6） mmH g vs.（ 47. 1 ±5. 2） mmH g,（ 40. 3 ± 7. 6） mmH g vs.（ 57. 1 ± 5. 4） mmH g,（ 46 ± 14） % vs.（ 55 ± 13） %,P〈0. 05]. 48 h after treatment,PaO2,PaCO2 and FiO2in the observation group were also better than those in the control group（ P〈0. 05）. The duration of ventilator therapy in the observation group was shorter than that in the control group [（ 120. 4 ± 16. 2） h vs.（ 148. 9 ± 19. 3） h,（ P〈0. 05） ]; the mortality of the observation group（ 6. 8%） was lower than that of the control group（ 26. 8%）,（ P〈0. 05）.However,the differences of the incidence of complications between two groups showed no significance（ P〈0. 05）. Conclusions Combined HFOV with iN O is significantly effective i

关 键 词：一氧化氮 呼吸功能不全 高频通气 婴儿 新生 

分 类 号：R722.19[医药卫生—儿科]