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目的探讨高频震荡通气(high frequency oscillatory ventilation,HFOV)在治疗合并气漏的新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)中应用价值。方法 40例合并气漏的NRDS患儿,25例经HFOV治疗者为HFOV组,15例行常频通气(conventional mechanical ventilation,CMV)治疗者为CMV组。比较治疗前、后2组pa(O_2)、pa(CO_2)、吸入氧浓度(fraction of inspired oxygen,FiO_2)、氧合指数(oxygenation index,OI)的变化,比较2组机械通气时间、闭式胸膜腔引流时间、住院时间及疗效。结果辅助机械通气8h,HFOV组pa(O_2)[(10.0±1.2)kPa]高于CMV组[(9.1±0.9)kPa](P<0.05),OI[(13.8±1.9)kPa]、pa(CO_2)[(5.8±0.9)kPa]、FiO_2[(72.0±5.0)%]低于CMV组[(14.3±1.8)kPa、(6.0±0.4)kPa、(80.0±5.0)%](P<0.05),24、48h时以上指标继续好转,2组比较差异有统计学意义(P<0.05);HFOV组通气时间[(5.90±0.58)d]、闭式胸膜腔引流时间[(6.97±0.34)d]、住院时间[(12.08±0.99)d]低于CMV组[(7.24±0.71)、(8.10±0.56)、(15.20±1.26)d](P<0.05),治愈率(92%)与CMV组(80%)比较差异无统计学意义(P>0.05)。结论与CMV相比,应用HFOV治疗合并气漏的NRDS更具优势,可作为临床治疗首选通气模式。
Objective To investigate the value of high frequency oscillatory ventilation (HFOV) in the treatment of neonatal respiratory distress syndrome (NRDS) with air leaks. Methods Forty infants with NRDS with air leaks, 25 HFOV-treated patients were treated with HFOV, and 15 with routine mechanical ventilation (CMV) were treated with CMV. The changes of pa (O 2), pa (CO 2), fraction of inspired oxygen (FiO 2) and oxygenation index (OI) in the two groups before and after treatment were compared. Pleural drainage time, length of stay and efficacy. Results Compared with CMV group, pa (O 2) [(10.0 ± 1.2) kPa] in HFOV group was significantly higher than that in CMV group [(9.1 ± 0.9) kPa] (P <0.05), (P <0.05), (P <0.05), (P <0.05) ), The indicators above 24,48h continued to improve, the difference between the two groups was statistically significant (P <0.05); the ventilation time of HFOV group [(5.90 ± 0.58) d], the time of closed pleural drainage [(6.97 ± 0.34) (12.08 ± 0.99) d] were lower than those in CMV group (7.24 ± 0.71 vs 8.10 ± 0.56, 15.20 ± 1.26, respectively] (P <0.05) There was no significant difference in CMV group (80%) (P> 0.05). Conclusion Compared with CMV, the application of HFOV in the treatment of air leak combined with NRDS has more advantages and can be used as the preferred ventilation mode for clinical treatment.