高频振荡通气在新生儿呼吸窘迫综合征治疗中的应用

目的探讨高频振荡通气在治疗新生儿呼吸窘迫综合征中的应用价值。方法采用完全随机设计方法，将62例呼吸窘迫综合征早产儿分为观察组与对照组。观察组32例采用HFOV治疗，对照组30例采用常频机械通气并经气管导管内单体位（仰卧位）一次性按200mg／kg快速滴注固尔苏。观察两组治疗前后氧分压、二氧化碳分压、肺泡一动脉氧分压差（A—aDO2）、氧舍指数的改变并比较两组间的差异。结果观察组患儿经HFOV治疗1h后氧分压明显上升为（72．2±12．5）rnmHg（P〈0．05），二氧化碳分压显著下降为（50．9±8．9）mmHg（P〈0．01），氧合指数迅速下降为6．0±2．5（P〈0．05），A—aDO2，上升为（0．45±0．11）mmHg（P〈0．05）。治疗3h、6h、12h、24h的氧分压、二氧化碳分压、氧合指数、A—aDO2与对照组比较差异无统计学意义。结论HFOV用于治疗新生儿呼吸窘迫综合征，是一种安全性好、疗效肯定的机械通气方法。

High Frequency Oscillation Ventilation for Neonatal Respiratory Distress Syndrome

Objective To study the value of high-frequency oscillatory ventilation （HFOV） in treating the neonatal respiratory distress syndrome（NRDS）. Methods Sixty two premature infants with NRDS were divided into the experimental group （32 cases） and control group（30 cases）. The experimental group received HFOV, whereas control group received the conventional mechanical ventilation and one time quick drip of Curosurf（200 mg/kg） by tracheal tube at beginning of the treatment. The PaO2, PaCO2 , A-aDO2 and OI before and after the treatment were observed and compared. Results One hours after the HFOV therapy, PaC02, OI were obviously decreased PaCO2 ： （50.9 ± 8.9） mm Hg, OI ： 6.0 ± 2.5 ] and PaO2, A-aDO2 was increased PaO2 ： （72.2 ± 12.5 ） mm Hg, A-aDO2 ： （0.45 ± 0.11 ） mm Hg] in the experimental group, and the difference between the two groups was statistically significant（ P 〈 0.01 ,P 〈 0.05 ） ; But there were no statistically significant in the difference of PaO2, PaCO2 , OI and A-aDO2 on 3,6,12,24 hours after therapy between two groups. Conclusion HFOV is a safe and effective mechanical ventilation method for NRDS.