高频振荡通气在新生儿重症肺疾病中的应用  

High frequency oscillatory ventilation in neonates with sevare pulmonary disease

作　　者：苏卫东[1] 瞿尔力[1] 叶雯[1] 包曼华[1] 

机构地区：[1]温州市第二人民医院儿科,温州市新生儿救治中心,浙江温州325000

出　　处：《小儿急救医学》2003年第6期363-365,共3页Pediatric Emergency Medicine

摘　　要：目的　 为观察高频振荡通气 (HFOV)治疗新生儿重症肺疾病的应用价值及安全性。 方法 　 2 7例新生儿重症肺疾病 ,15例应用HFOV治疗 ,12例应用常频机械通气 (CMV)治疗 ,观察治疗前后 2 4h内氧合参数及呼吸机参数的变化。 结果 　HFOV组 2 4h内氧浓度 (FiO2 )迅速从 ( 0 85± 0 11)降至 ( 0 5 3± 0 0 8) ,P <0 0 1;平均气道压 (MAP)从 ( 15 3± 1 8)cmH2 O降至( 11 2± 2 1)cmH2 O(P <0 0 1) ,氧合指数 (OI)从 ( 3 4± 10 )降至 ( 2 0± 4) (P <0 0 1) ,二氧化碳分压 (PCO2 )从 ( 6 9± 0 8)kPa迅速降至 ( 5 4± 0 9)kPa(P <0 0 1)。HFOV期间血压、心率无明显变化。 结论 　HFOV治疗新生儿重症肺疾病 ,通气效果优于CMV ,氧合改善快 ,短时间内氧浓度、MAP下降更快 ,是一种疗效肯定、安全性好的新型机械通气方法。Objective To investigate and eveluate the application and safety of high frequency oscillatory ventilation (HFOV) in the treatment of severe pulmonary disease in neonates.Methods Among 27 neonates with severe pulmonary disease,15 neonates were treated by HFOV,12 neonates were treated by conventional mechanical ventilation (CMV).Changes of oxygen and respiratory ventilation parameters were observed in 24 before and after the therapy.Results FiO\-2 rapidly decreased from (0.85±0.11) to (0.53±0.08)(F=28.90,P<0.01) in HFOV group. Mean airway pressure decreased from (15.3±1.8) to (11.2±2.1)cmH\-2O (F=8.34,P<0.01),oxygen index decreased from (34±10) to (20±4) (F=9.03 P<0.01),PCO 2 decreased from (6.9±0.8) to (5.4±0.9) kPa(F=6.75 P<0.01).Conclusion Compared HFOV and CMV treatment in neonates with severe pulmonary disease, the former is better in ventilation effect and oxygenation improvement. FiO\-2,MAP are decreased more rapidly in HFOV group than that in CMV group.

关 键 词：高频振荡通气 新生儿 重症肺疾病 安全性 常频机械通气 

分 类 号：R722.1[医药卫生—儿科]