高频振荡通气治疗重症新生儿胎粪吸入综合征的临床疗效探讨

目的：探讨高频振荡通气（ HFOV）与常频机械通气（ CMV）治疗重症新生儿胎粪吸入综合征（ MAS）的临床疗效。方法将60例重症MAS患儿随机分为CMV组与HFOV组各30例，动态监测两组患儿48 h 内的pH 值、氧气分压（PaO2）、二氧化碳分压（PaCO2）、吸入氧浓度（FiO2）、氧合指数（OI）等变化情况，比较两组患儿的并发症及临床转归。结果两组患儿上机前（0 h）的pH 值、PaO2、PaCO2、FiO2、OI 差异均无统计学意义（P ＞0.05），上机后在2、12、24、48 h 时间点上，差异均有统计学意义（P 均＜0.05）；两组患儿在平均上机时间比较差异有统计学意义（t ＝3.197，P ＝0.002）；两组患儿上机后的并发症比较差异有统计意义（χ2＝4.043，P ＝0.044）；两组患儿的治愈率比较差异有统计学意义（χ2＝4.320，P ＝0.038）。结论 HFOV 治疗重症MAS 安全、有效。

Application of high-frequency oscillatory ventilation in meconium aspiration syndrome

Objective To evaluate the efficiency of conventional mechanical ventilation （ CMV） and high-frequency oscillatory ventilation （ HFOV） in the treatment of neonates meconium aspiration syndrome （ MAS） .Meth-ods Sixty neonates with MAS were randomly divided into CMV group （30 cases） and HFOV group（30 cases）.The parameter of pH , PaO2 , PaCO2 , FiO2 （ inhaled oxygen concentration ） ,OI（ oxygen index ） were monitored before and after mechanical ventilation .Complications and clinical outcomes were compared .Results The pH, PaO2 , PaCO2 , FiO2, OI at 0 h between the two groups were not statistically significant difference （P＆gt;0.05）.At 2 hours, 12 hours, 24 hours,48 hours after ventilation , pH, PaO2 , PaCO2 , FiO2 , OI in the HFOV group improved more quickly than those in the CMV group , with statistically significant difference （ P＆lt;0.05 ） .Mechanical ventilation time in the HFOV group was more shorter than that in the CMV group , with statistically significant difference （t=3.197,P=0.002）. The complications of mechanical ventilation hade statistically significant difference between two groups （χ2 =4.043,P=0.044）.The cure rate had statistically significant difference between two groups （χ2 =4.320,P=0.038）.Conclu-sion HFOV is a safe and effective means for the treatment of severe MAS .