高频振荡叠加常频通气治疗新生儿肺出血的临床研究  

Clinical Analysis on High-frequency Oscillatory Ventilation Combined with Conventional Mechanical Ventilation in the Treatment of Neonatal Pulmonary Hemorrhage

作　　者：廖燕 黄国盛 陆岸锋 LIAO Yan;HUANG Guosheng;LU Anfeng(Qinzhou Meternal and Child Health Care Hospital,Guangxi,Qinzhou 535099,China;不详)

机构地区：[1]广西钦州市妇幼保健院,广西钦州535099

出　　处：《中国医学创新》2022年第18期25-28,共4页Medical Innovation of China

基　　金：广西钦州市科学研究及技术开发计划项目(20211209)。

摘　　要：目的:探讨高频振荡叠加常频通气治疗新生儿肺出血的有效性及安全性。方法:回顾性分析2019年1月-2020年6月钦州市妇幼保健院新生儿重症监护病房收治的新生儿肺出血需机械通气49例患儿的临床资料,根据治疗方式将其分为观察组(n=25,高频振荡叠加常频通气模式)与对照组(n=24,高频振荡通气模式)。比较两组氧合指数(OI)、肺出血时间、机械通气时间、氧疗时间、住院天数、住院费用、并发症及转归预后情况。结果:两组组内不同治疗时间OI比较,差异均有统计学意义(P<0.05);且观察组治疗后1、6、12、24、48、72 h的OI均低于对照组(P<0.05)。观察组肺出血时间、机械通气时间、氧疗时间、住院天数均较对照组缩短,住院费用较对照组减少(P<0.05)。两组气胸、颅内出血、消化道出血、支气管肺发育不良(BPD)、呼吸机相关性肺炎(VAP)及持续性肺动脉高压(PPHN)发生率及死亡率相比,差异均无统计学意义(P>0.05)。结论:高频振荡叠加常频通气治疗新生儿肺出血,与单纯应用高频通气模式相比,可更好改善肺出血患儿氧合功能,缩短肺出血时间、机械通气时间、氧疗时间、住院时间,减少住院费用,且未增加并发症发生率与死亡率。Objective:To investigate the clinical efficacy and safety of high-frequency oscillatory ventilation(HFOV)combined with conventional mechanical ventilation(CMV)in the treatment of neonatal pulmonary hemorrhage.Method:The clinical data of 49 cases of neonatal pulmonary hemorrhage requiring mechanical ventilation in the neonatal intensive care unit of Qinzhou Maternal and Child Health Care Hospital from January 2019 to June 2020 were retrospectively analyzed.They were divided into observation group(n=25,HFOV+CMV)and control group(n=24,HFOV)according to the treatment mode.The oxygenation index(OI),duration of pulmonary hemorrhage,length of mechanical ventilation,oxygen therapy,hospital stay,hospitalization costs,complications and outcome were compared between two groups.Result:There were statistically significant differences in OI of two groups at different treatment time points(P<0.05).Compared with the control group,the observation group had significantly lower OI at 1,6,12,24,48 and 72 h after treatment(P<0.05).Compared with the control group,the observation group had significantly shorter duration of pulmonary hemorrhage,mechanical ventilation and oxygen therapy and hospital stay and lower hospitalization costs(P<0.05).There were no statistically significant differences in the incidences of pneumothorax,intracranial hemorrhage,digestive tract hemorrhage,BPD,VAP and PPHN and mortality in two groups(P>0.05).Conclusion:Compared with HFOV alone,HFOV combined with CMV may improve oxygenation function,shorten the duration of pulmonary hemorrhage,mechanical ventilation,oxygen therapy and hospital stay and reduce the hospitalization costs,meanwhile,it does not increase the incidence of complications and mortality.

关 键 词：高频振荡通气 常频通气 肺出血 

分 类 号：R722.1[医药卫生—儿科]