高频振荡通气治疗新生儿肺出血疗效观察

目的观察高频振荡通气(HFOV)治疗新生儿肺出血(NPH)的临床疗效。方法对30例NPH患儿进行HFOV治疗,对上机前及上机后2,6,12,24 h吸入氧浓度(FiO2)、氧合指数(OI)、二氧化碳分压(PaCO2)进行比较。结果 30例NPH治愈23例(76.7%),包括4例常频机械通气无效及1例常频机械通气发生气漏改为HFOV治疗治愈者,死亡5例(16.7%),自动出院2例。肺出血时间(14.4±7.6)h,机械通气时间(77.4±21.2)h,无发生气漏,发生脑室内出血4例(17.4%)。存活患儿HFOV后2,6,12,24 h FiO2、OI、PaCO2均显著下降(P<0.01)。结论 HFOV治疗可以明显改善NPH患儿氧合功能,迅速改善高碳酸血症。HFOV治疗NPH安全、有效,具有较好的临床应用价值。

The effect of High-frequency oscillatory ventilation on treatment of neonatal pulmonary hemorrhage

Objective To investigate therapeutic effect of high-frequency oscillatory ventilation(HFOV)on neonatal pulmonary hemorrhage(NPH).Methods Thirty newborns with NPH were treated by HFOV.FiO2,OI,and PaCO2were measured before and after the treatment by HFOV.Results 23 were cured(76.7%),including 4 which failed in CMV and 1 with frequent hemorrhoid.5 died(16.7%),2 were discharged free of treatment.4 had incidence of ventricular hemorrhage(17.4%)and no frequent hemorrhoid.The duration of pulmonary was(14.4±7.6)h and the duration of mechanical ventilation was(77.4±21.2)h.FiO2,OI and PaCO2of living babies were lower obviously at 2、 6、12、24h after treatment with HFOV(P<0.01).Conclusion HFOV is effective to improve the oxygenate function and hypercapnia.It is safe and effective to use HFOV in the treatment of NPH and it has clinic value.