高频振荡通气治疗新生儿重度胎粪吸入综合征的临床效果

目的：评价高频振荡通气（HFOV）及常频通气（SIMV）在治疗新生儿重度胎粪吸入综合征（MAS）的临床效果。方法：将2011年1月至2013年12月收住茂名市妇幼保健院新生儿重症监护室的43例 MAS 患儿随机分成2组，其中 HFOV 组23例、SIMV 组20例，两组分别于呼吸支持0、2、12、24、48 h时记录血氧饱和度（SaO2）、氧分压（PaO2）、二氧化碳分压（PaCO2）、动脉/肺泡氧分压比值（a/ APO2），并比较两组并发症及转归情况。结果：两组患儿性别、胎龄、出生体并重、分娩方式、入院日龄比较，差异均无统计学意义（P〉0.05），两组在2、12、24、48 h 时 PaO2、PaCO2、SaO2、a/ APO2各指标相比差异有统计学意义（P〈0.05），HFOV 组相关肺动脉高压、气漏均低于 SIMV 组（P〈0.05）。结论：HFOV 治疗新生儿 MAS 的效果优于 SIMV。

Clinical effect of high frequency oscillation ventilation for treating neonatal severe meconium aspiration syndrome

Objective：To explore the therapeutic effect of high frequency oscillatory ventilation（HFOV） and conventional positive mechanical ventilation （ SIMV） in theatment of meconium aspiration syndrome （ MAS）. Methods： 43 infants with severe MAS admitted to neonatal department of Guangdong Maomin health care for women and children hospital were randomly assigned to two groups, HFOV group had 23 cases and SIMV group had 20 cases.The parameters of SaO2 , PaO2 ,PaCO2 ,a/ APO2 were monitored at 0 h,12 h,24 h and 48h after treated with respiratory support.Complications and outcomes between the two gropes wer- e compared. Results：The two groups were similar in gender, gestational age, birth weight, delivery mode, admission age（P〉0.05）. The both groups had significant difference of SaO2 , PaO2 ,a/ APO2 at the time point of 0h, 12h,24h and 48h（P〈0.05）.The incidence of high pulmonary pressure and air leak in HFOV group were lower than SIMV group（P〈0.05）. Conclusions： HFOV was effective in treatment of neonatal MAS ,the effect was better than SIMV.