高频振荡通气治疗新生儿呼吸衰竭

High Frequency Oscillatory Ventilation in the Treatment of Respiratory Failure in Neonates

摘要:

目的： 探讨高频振荡通气(HFOV)对新生儿呼吸衰竭(呼衰)的治疗作用。方法： 对该院186例呼衰新生儿上机前后PaO2,PaCO2,SaO2进行比较,并对其中143例重度窒息合并胎粪吸入致呼衰患儿上机前后PaO2 /FiO2,a/APaO2,氧合指数变化进行比较。结果： 186例呼衰患儿治愈145例(77.96%) ,死亡2 7例(14 .51%) ,自动出院14例。所有患儿上机后8h复查血气,PaO2,SaO2分别较上机前明显上升[(7.50± 1.38)kPavs(4.37±0.49)kPa;(91.2 2±1.23)%vs (34 .70± 2 .92 )%] (P<0.01) ,PaCO2显著下降[(4.41± 0.37)kPavs(9.43±0.51)kPa](P<0.01)。143例重度窒息合并胎粪吸入致呼衰患儿上机后8h复查血气,氧合指数明显下降[(16±6)vs(23±7)](P<0.05),PaO2/FiO2,a/APaO2比值分别显著升高[(1 0± 5)vs(6± 4);(0.12±0.06)vs(0.07±0.05)] (P<0.01)。结论： HFOV可以明显改善呼衰新生儿肺部气体交换,对胎粪吸入患儿应及早行HFOV治疗

Abstract:

OBJECTIVE: To study the therapeutic effect of high frequency oscillatory ventilation (HFOV) on respiratory failure in neonates. METHODS: One hundred and eighty six neonates with respiratory failure were treated by HFOV. PaO2, PaCO2 and SaO2 were measured before and after the treatment of HFOV. Of the 186 cases, 143 developed respiratory failure from serious asphxia complicated by the meconium aspiration. Besides PaO2, PaCO2 and SaO2, PaO2/FiO2, a/A PaO2 and oxygenation index were measured in the 143 cases. RESULTS: Eight hours after the treatment of HFOV, compared with the condifion before the treatment, PaO2 and SaO2 increased significantly [( 7.50 ± 1.38 ) kPa vs ( 4.37 ± 0.49 ) kPa and ( 91.22 ± 1.23 )% vs ( 34.70 ± 2.92 ) %, respectively](P< 0.01 ) and PaCO2 decreased significantly [( 4.41 ± 0.37 ) vs ( 9.43 ± 0.51 ) kPa](P< 0.01 ) in 186 cases; the oxygenation index decreased significantly [(16±6) vs (23±7)](P< 0.05 ) and the ratio of P aO 2/F iO 2 and a/A P aO 2 were elevated significantly [(10±5) vs (6±4) and ( 0.12 ± 0.06 ) vs ( 0.07 ± 0.05 ),respectively](P< 0.01 ) in 143 cases. Of the 186 cases, 145 were cured ( 77.96% ), 27 died ( 14.51% ) and 14 were discharged free of treatment. CONCLUSIONS: HFOV is effective on improving pulmonary air exchange in neonates with respiratory failure. It is necessary to use HFOV in infants with meconium aspiration earlier.