容量保证下的高频振荡通气与常频机械通气治疗新生儿呼吸窘迫综合征的效果比较  

Comparison of effects of high frequency oscillatory ventilation with volume guarantee and conventional mechanical ventilation in treatment of neonatal respiratory distress syndrome

作　　者：陈凯 CHEN Kai(Department of Neonatology of Shangrao Maternal and Child Health Hospital,Shangrao 334000 Jiangxi,China)

机构地区：[1]上饶市妇幼保健院新生儿科,江西上饶334000

出　　处：《中国民康医学》2024年第3期153-155,159,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较容量保证下的高频振荡通气(HFOV-VG)与常频机械通气治疗新生儿呼吸窘迫综合征(NRDS)的效果。方法:选取2019年1月至2022年12月该院收治的70例NRDS患儿进行前瞻性研究,依照随机数字表法将其分为对照组与观察组各35例。两组患儿均予以肺表面活性物质治疗,在此基础上对照组予以常频机械通气治疗,观察组予以HFOV-VG治疗。治疗3 d后比较两组临床疗效,治疗前后血气指标[动脉血pH值、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))]水平、呼吸力学指标[呼气时气道阻力(Re)、吸气时气道阻力(Ri)和肺动态顺应性(Cdyn)]水平,机械通气时间,住院时间,以及并发症发生率。结果:观察组治疗总有效率为97.14%(34/35),高于对照组的77.14%(27/35),差异有统计学意义(P<0.05);治疗后,观察组动脉血pH值、PaO_(2)及Cdyn水平均高于对照组,PaCO_(2)、Re、Ri水平均低于对照组,差异有统计学意义(P<0.05);观察组机械通气时间和住院时间均短于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.71%(2/35),低于对照组22.86%(8/35),差异有统计学意义(P<0.05)。结论:与常频机械通气相比,HFOV-VG治疗NRDS患儿可提高临床疗效,改善患儿血气指标,降低气道阻力,提高肺顺应性,缩短机械通气时间和住院时间,同时降低并发症发生率。Objective:To compare effects of high frequency oscillatory ventilation with volume guarantee(HFOV-VG)and conventional mechanical ventilation in treatment of neonatal respiratory distress syndrome(NRDS).Methods:A prospective study was conducted on 70 children with NRDS admitted to the hospital from January 2019 to December 2022.They were divided into control group and observation group according to the random number table method,35 cases in each group.Both groups were treated with pulmonary surfactant.On this basis,the control group was treated with conventional mechanical ventilation,while the observation group was treated with HFOV-VG.After 3 days of treatment,the clinical efficacy,the blood gas indexes[arterial blood pH value,arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2))],the respiratory mechanics indexes[expiratory airway resistance(Re),inspiratory airway resistance(Ri)and pulmonary dynamic compliance(Cdyn)]levels before and after the treatment,the mechanical ventilation time,the hospitalization time,and the incidence of complications were compared between the two groups.Results:The total effective rate of the observation group was 97.14%(34/35),which was higher than 77.14%(27/35)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the arterial blood pH,PaO_(2) and Cdyn in the observation group were higher than those in the control group,the PaCO_(2),Re and Ri were lower than those in the control group,and the differences were statistically significant(P<0.05).The mechanical ventilation time and the hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 5.71%(2/35),which was lower than 22.86%(8/35)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Compared with conventional mechanical ventilation,HFOV-VG can improve

关 键 词：高频震荡通气 常频机械通气 容量保证 新生儿呼吸窘迫综合征 血气指标 

分 类 号：R722.1[医药卫生—儿科]