高频通气联合肺复张治疗新生儿呼吸窘迫综合征的疗效  

Efficacy of high frequency oscillatoryventilation combined with lung recruitmentmaneuvers on neonatal respiratory distress syndrome

作　　者：王丹丹[1] 张家洁[1] 孙健伟[1] 张美慧[1] 王慧杰 刘梦迪 WANG Dan-dan;ZHANG Jia-jie;SUN Jian-wei;ZHANG Mei-hui;WANG Hui-jie;LIU Meng-di(NICU,Henan Provincial People's Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院NICU,郑州450000

出　　处：《医药论坛杂志》2024年第1期1-4,共4页Journal of Medical Forum

基　　金：河南省二〇一八年科技发展计划(182102311193)。

摘　　要：目的探讨高频振荡通气联合肺复张治疗新生儿呼吸窘迫综合征(respiratory distress syndrome,RDS)的疗效及对患儿心肌酶的影响。方法将河南省人民医院收治的100例新生儿RDS患儿随机分为对照组与观察组每组50例,两组均必要时应用肺表面活性物质(pulmonary surfactant,PS)、机械通气等对症处理,观察组患儿采用高频振荡通气联合肺复张策略,比较两组患儿治疗前后血气指标[酸碱值(potential of hydrogen,pH)、吸入氧分数(fraction of inhaled oxygen,FiO2)、氧合指数(oxygenation index,OI)]、心肌酶[肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)]的变化,记录患儿治疗过程中达最低FiO2时间、肺表面活性物质应用次数、吸氧时间、呼吸机支持时间及并发症发生情况。结果观察组复张12 h pH值高于对照组,FiO2、OI低于对照组(P<0.05),其治疗过程达最低FiO2时间、吸氧时间及呼吸机支持时间均短于对照组,肺表面活性物质应用次数比较无统计学意义(P>0.05);复张12 h,观察组心肌酶低于对照组(P<0.05);两组并发症发生率比较无统计学意义(P>0.05)。结论高频振荡通气联合肺复张治疗新生儿RDS减少了吸氧时间、吸氧浓度及呼吸机支持时间,疗效较好,同时减轻了心肌受损程度。Objective To explore the effects of high frequency oscillatory ventilation combined with lung recruitment ma⁃neuvers on neonatal respiratory distress syndrome(RDS)and its influence on myocardial enzymes.Methods Totally 100 children patients with neonatal RDS were randomly divided into control group and observation group,with 50 cases in each group.The two groups were given necessarily symptomatic treatments of pulmonary surfactant and mechanical ventilation,and observation group was given high frequency oscillatory ventilation combined with lung recruitment ma⁃neuvers.The blood gas indicators[potential of hydrogen(pH),fraction of inhaled oxygen(FiO2),oxygenation index(OI)],and myocardial enzymes[creatine kinase(CK),creatine kinase isoenzyme(CK-MB)]were compared be⁃tween the two groups before and after treatment,and the time of reaching the minimum FiO2,frequency of pulmonary surfactant application,oxygen inhalation time,ventilator support time and occurrence of complications were recorded a⁃mong children patients.Results The pH value in observation group was higher than that of control group at 12 h of lung recruitment maneuvers while the FiO2 and OI were lower than those of control group(P<0.05),and the time of reac⁃hing the minimum FiO2,oxygen inhalation time and ventilator support time were shorter than those of control group,and there was no significant difference in the frequency of pulmonary surfactant application(P>0.05).At 12 h of lung re⁃cruitment maneuvers,the myocardial enzymes in observation group were lower than those of control group(P<0.05).There was no significant difference in the incidence rate of complications between the two groups(P>0.05).Conclusion High frequency oscillatory ventilation combined with lung recruitment maneuvers for neonatal RDS reduces oxygen inhalation time,oxygen concentration and ventilator support time,with good efficacy,and reduces the degree of myocardial damage.

关 键 词：高频振荡通气 肺复张 新生儿呼吸窘迫综合征 心肌酶 

分 类 号：R722[医药卫生—儿科]