目的探讨高频振荡通气(HFOV)联合吸入一氧化氮(i NO)治疗新生儿难治性呼吸衰竭的临床疗效。方法选择我院出生并入住新生儿重症监护病房诊断为难治性呼吸衰竭的新生儿,随机分为观察组和对照组,观察组应用HFOV联合i NO治疗,对照组应用HFOV治疗。观察两组患儿治疗前及治疗后1、12、24、48 h血气、吸入氧浓度(FiO_2)等指标的变化及并发症发生情况。结果共纳入85例患儿,观察组44例,对照组41例。两组患儿性别、胎龄、出生体重、原发病等比较差异均无统计学意义(P>0.05)。治疗前两组PaO_2、PaCO_2、FiO_2差异均无统计学意义(P>0.05)。治疗后24 h观察组PaO_2高于对照组[(67.2±7.6)mm Hg比(47.1±5.2)mm Hg],PaCO_2和FiO_2低于对照组[(40.3±7.6)mm Hg比(57.1±5.4)mm Hg,(46±14)%比(55±13)%,P<0.05];治疗后48 h观察组PaO_2、PaCO_2、FiO_2亦均优于对照组,差异有统计学意义(P<0.05)。观察组呼吸机使用时间短于对照组,病死率低于对照组[(120.4±16.2)h比(148.9±19.3)h,6.8%比26.8%,P<0.05]。两组并发症发生率差异无统计学意义(P>0.05)。结论 HFOV联合i NO治疗新生儿难治性呼吸衰竭疗效显著,可显著改善氧合,提高患儿存活率。患儿短时间、低剂量i NO治疗未发生严重不良反应。 Objective To investigate the clinical efficacy of high frequency oscillatory ventilation (HFOV) combined with inhaled nitric oxide (i NO) in the treatment of neonatal refractory respiratory failure. Methods Neonates born in our hospital and diagnosed as refractory respiratory failure in neonatal intensive care unit were randomly divided into observation group and control group. The observation group was treated with HFOV combined with i NO, while the control group was treated with HFOV. The change of blood gas and the concentration of inhaled oxygen (FiO 2) and the incidence of complications before and after treatment were observed at 1, 12, 24 and 48 h after treatment in both groups. Results A total of 85 cases were enrolled in the study group, 44 cases in the observation group and 41 cases in the control group. There were no significant differences in gender, gestational age, birth weight, primary disease between the two groups (P> 0.05). PaO2, PaCO2 and FiO2 were not significantly different between the two groups before treatment (P> 0.05). PaO_2 in the observation group was significantly higher than that in the control group [(67.2 ± 7.6) mm Hg vs (47.1 ± 5.2) mm Hg), PaCO_2 and FiO_2 were lower than those in the control group [(40.3 ± 7.6) mm Hg vs (57.1 ± 5.4) mmHg, (46 ± 14)% vs (55 ± 13)%, P <0.05]. PaO_2, PaCO_2 and FiO_2 in the observation group at 48 hours after treatment were also better than those in the control group (P <0.05) . The use of ventilator in the observation group was shorter than that of the control group, and the mortality was lower than that of the control group [(120.4 ± 16.2) h (148.9 ± 19.3) h, 6.8% vs 26.8%, P <0.05]. There was no significant difference in the incidence of complications between the two groups (P> 0.05). Conclusion HFOV combined with i NO treatment of neonatal refractory respiratory failure significant effect, can significantly improve oxygenation and improve the survival rate of children. Short-term children, low-dose i NO treatment did not occur serious adverse reactions.