高频机械通气治疗晚期早产儿重症呼吸衰竭的效果

目的探讨高频机械通气（HFV）用于晚期早产儿重症呼吸衰竭治疗的效果及安全性。方法对入住我院新生儿重症监护病房的晚期早产新生儿19例，出现呼吸衰竭后均常规给予常频机械通气，疗效不佳者转为HFV。记录HFV治疗后6、12、24、48h血气分析及呼吸机参数变化。结果19例病儿HFV治疗6h后血气pH、PaO2、PaCOz均较治疗前显著改善（t=-10．71～8．72，P〈O．05），12、24、48h进一步改善并且维持相对稳定；吸人氧浓度（FiOz）、动脉氧分压与吸人氧浓度之比（PaO：／FiO：）、氧合指数（OI）、动脉肺泡氧分压比值（a／A）治疗后6h与治疗前比较差异亦有显著性（t=-4．15～5．57，P〈0．05），12、24、48h进一步改善。19例病儿治愈15例（78．9％），4例（21．0％）因病重放弃治疗后死亡。结论HFV治疗晚期早产儿重症呼吸衰竭是安全有效的

EFFECT OF HIGH-FREQUENCY OSCILLATORY MECHANICAL VENTILATION ON ADVANCED STAGE PRETERM INFANTS WITH SEVERE RESPIRATORY FAILURE

Objective To investigate the effect and safety of high frequency oscillatory mechanical ventilation （HFOMV） on advanced-stage infants with severe respiratory failure. Methods Nineteen advanced-stage preterm infants who were treated in newborn ICU in our hospital were recruited for this study. A conventional mechanical ventilation was offered to those with respira tory failure, when the effect was not good, HFOMV was then applied. Blood gas and changes of ventilator parameters were recor ded after 6, 12, 24, and 48 hours of the treatment with HFOMV. Results pH, PaOz and PaCO2 of the 19 sick kids improved after 6-hour therapy versus before HFOMV （t=-10.71-8.72 ,P〈0. 05）, a further improvement and stabilization were observed after 12 h, 24 h, and 48 h. Fraction of inspired oxygen （FiOz）, arterial oxygen partial pressure of inspired oxygen （PaO2/FiO2 ）, oxygenation index （OI）, and arterial alveolar oxygen tension ratio （a/A） after 6-hour of the treatment improved versus before （t=-4.15-5.57,P〈0.05）, which were improved further at 12, 24, 48 h. Of whom,15（78.9%） were cured, and four died ofseri ously ill. Conclusion HFOMV is safe and effective in the treatment of preterm infants with severe respiratory failure.