高频振荡通气治疗婴幼儿心脏术后急性肺水肿临床研究

目的探讨高频通气(HFOV)治疗婴幼儿心脏术后急性肺水肿的临床疗效。方法将24例婴幼儿心脏术后并发急性肺水肿患儿分为A、B两组。A组(治疗组)12例,采用高频通气治疗,B组(对照组)12例采用常频呼吸机通气治疗。观察A、B两组病例,血气分析:动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)、氧合指数(OI)的变化及临床症状:血性泡沫痰的变化。结果 A组治疗后的PaO2、PaCO2、SaO2、OI明显改善。P均<0.05,且A组治疗后呼吸机辅助时间、PaO2、PaCO2改善时间、血性泡沫痰吸收时间均较B组短、且气胸发生率低,提示A组在改善通气、氧合、血性泡沫痰吸收、肺水肿清除方面明显优于B组。结论 HFOV用于婴幼儿心脏术后并发急性肺水肿疗效显著、肯定、安全性好,是值得临床推广应用的新型机械通气模式。

HFOV Treatment of Infant Cardiac Surgery Clinical Study of Acute Pulmonary Edema

Objective To explore the clinical effects of high-frequency ventilation （HFDV） in treating acute pulmonary edema in infants after cardiac surgery. Methods 24 cases of infant cardiac surgery complicated by acute pulmonary edema were divided into two groups named group A and group B. 12 cases from group A （treatment group） used high-frequency ventilation in the treatment, another 12 cases from group B （control group） were treated by normal frequency ventilator therapy. Observe the variations of arterial partial pressure of oxygen （PaO2）, arterial carbon dioxide partial pressure （PaCO2）, arterial oxygen saturation （SaO2）, oxygenation index （OI） and sputum bloody foam. Results PaO2, PaCO2, SaO2, OI of group A after treatment improved significantly, P 〈0.05, Mechanical ventilation time, improvement time of PaO2 and PaCO2, bloody sputum foam absorption time of group A after treatment were shorter than those of group B, and group A had a lower incidence of pneumothorax. It suggested that group A was obviously superior to group B in improving the ventilation, oxygenation, bloody sputum bubble absorption and clearance of pulmonary edema. Conclusion The effect of HFOV for infants and young children after cardiac surgery complicated by acute pulmonary edema is significant, affirmative and secure. It is a new mechanical ventilation mode worthy of clinical popularization and application.