高频呼吸机治疗足月儿 MAS 的临床效果研究

目的：观察高频呼吸机治疗足月儿 MAS 的临床效果。方法：以2012年3月～2015年6月在我院接受治疗的胎粪吸入综合征患儿为观察对象，根据其治疗方式分为常频机械通气组和高频机械通气组，每组各40例患儿。观察两组患儿机械通气时间，比较两组患儿治疗前后血氧指标的变化，并对两组患儿的疾病转归进行观察。结果：高频机械通气组患儿的总机械通气时间、撤机后给氧时间均短于常频机械通气组，差异有统计学意义；两组患儿通气前的吸入氧分数、氧分压、二氧化碳分压和血酸碱度无明显差别，通气4小时和12小时后，高频机械通气组吸入氧分数、二氧化碳分压低于常频机械通气组，氧分压和血酸碱度高于常频机械通气组，差异具有统计学意义；两组患儿死亡、颅内出血、肺出血和呼吸机相关性肺炎发生率无明显差别，而高频机械通气组视网膜病变的发生率明显低于常频机械通气组。结论：高频呼吸机对足月儿 MAS 有较好的治疗效果，且并发症发生率低，具有临床应用价值。

The clinical effect of high frequency ventilator in the treatment of MAS in term infants

Objective To observe the clinical effect of high frequency ventilator in the treatment of MAS in term infants. Methods Meconium aspiration syndrome patients treated in our hospital from March 2012 to June 2015 were selected as the observation object, according to its treatment, which were divided into constant frequency mechanical ventilation group and high frequency mechanical ventilation group, 40 cases in each children. The mechanical ventilation time, compared with the two groups before and after treatment of blood oxygen index changes were compared, and the two groups of patients with the disease outcome were observed. Results The total mechanical ventilation time and the oxygen supply time were shorter than the normal frequency mechanical ventilation group, and the difference was statistically significant; Ventilation of the two groups of children in front of the fraction of inspired oxygen, oxygen partial pressure, carbon dioxide pressure and blood acid-base degree had no significant difference, ventilation 4 hours and 12 hours later, the high frequency mechanical ventilation group inhaled oxygen concentration, carbon dioxide partial pressure is less than the normal frequency mechanical ventilation group, oxygen partial pressure and blood pH value higher than normal frequency mechanical ventilation group, the difference has statistical signifi-cance. The death, intracranial hemorrhage, pulmonary hemorrhage and incidence of ventilator-associated pneumonia had no significant difference, while the high frequency mechanical ventilation group retinopathy incidence was significantly lower than that of conventional mechanical ventilation group. Conclusion High frequency ventilator has good effect on the treatment of preterm MAS, low complication rate and has clinical application value.