高频振荡通气与常频机械通气交替应用治疗早产儿呼吸窘迫综合征的疗效观察  

Alternate application efficacy of high-frequency oscillatory ventilation and constant-frequency mechanical ventilation in the treatment of premature infants with respiratory distress syndrome

作　　者：陈震[1] 陈静[1] Chen Zhen;Chen Jing(Department of Pediatrics,the Maternal and Child Health Hospital of Taian,Taian,Shandong 271000,China)

机构地区：[1]泰安市妇幼保健院儿科,山东省271000

出　　处：《中国基层医药》2020年第5期541-545,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨高频振荡通气与常频机械通气交替应用治疗早产儿呼吸窘迫综合征的疗效。方法选取泰安市妇幼保健院2015年4月至2017年8月收治的早产儿呼吸窘迫综合征174例进行研究,采用随机数字表法将其分为三组,常频组采用常频机械通气治疗,高频组采用高频振荡通气治疗,交替应用组联合常频机械通气与高频振荡通气治疗,治疗后比较三组患儿用氧时间、机械通气时间、氧合功能、并发症及存活情况。结果交替应用组用氧时间及机械通气时间均较常频组和高频组短,差异均有统计学意义(均P<0.05)。治疗开始后各组患儿动脉血氧分压(PaO2)与动脉血氧分压与吸入氧浓度比(PaO2/FiO2)增高,动脉血二氧化碳分压(PaCO2)、氧合指数(OI)与呼吸指数(RI)降低,与治疗前比较差异均有统计学意义(均P<0.05)。治疗12 h、24 h及48 h时交替应用组PaO2与PaO2/FiO2高于常频组与高频组,PaCO2、OI与RI低于常频组与高频组,差异均有统计学意义(均P<0.05)。三组患儿并发症发生率及存活率差异均无统计学意义(均P>0.05)。结论高频振荡通气与常频机械通气交替应用治疗早产儿呼吸窘迫综合征有利于提高氧合功能,缩短用氧时间与机械通气时间,安全性良好。Objective To investigate the alternate application efficacy of high-frequency oscillatory ventilation and constant-frequency mechanical ventilation in the treatment of premature infants with respiratory distress syndrome.Methods From April 2015 to August 2017,174 premature infants with respiratory distress syndrome were chosen in this research and randomly divided into three groups.CF group was treated with constant-frequency mechanical ventilation,HF group was treated with high-frequency oscillatory ventilation,AP group was treated with alternate application of constant-frequency mechanical ventilation and high-frequency oscillatory ventilation.After treatment,the oxygen time,mechanical ventilation time,oxygenation,complications and survival in the three groups were compared.Results The oxygen time,mechanical ventilation time of the AP group were shorter than those of the HF group and the CF group,the differences were statistically significant(all P<0.05).After treatment,the PaO2 and PaO2/FiO2 were increased in each group,and the PaCO2,OI and RI were decreased,and the differences were statistically significant compared with before treatment(all P<0.05).At 12 h,24 h and 48 h after treatment,the PaO2 and PaO2/FiO2 in the AP group were higher than those in the CF group and the HF group,the PaCO2,OI and RI were lower than those in the CF group and the HF group(all P<0.05).There were no statistically significant differences in the incidence of complications and survival rate among the three groups(all P>0.05).Conclusion Alternate application of high-frequency oscillatory ventilation and constant-frequency mechanical ventilation in the treatment of premature infants with respiratory distress syndrome can improve oxygenation,shorten oxygen time and mechanical ventilation time,with good safety.

关 键 词：呼吸窘迫综合征 早产儿 常频机械通气 高频振荡通气 

分 类 号：R722[医药卫生—儿科]