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目的探讨高频振荡通气在治疗新生儿呼吸窘迫综合征中的应用价值。方法采用完全随机设计方法,将62例呼吸窘迫综合征早产儿分为观察组与对照组。观察组32例采用HFOV治疗,对照组30例采用常频机械通气并经气管导管内单体位(仰卧位)一次性按200 mg/kg快速滴注固尔苏。观察两组治疗前后氧分压、二氧化碳分压、肺泡-动脉氧分压差(A-aDO2)、氧合指数的改变并比较两组间的差异。结果观察组患儿经HFOV治疗1 h后氧分压明显上升为(72.2±12.5)mm Hg(P<0.05),二氧化碳分压显著下降为(50.9±8.9)mm Hg(P<0.01),氧合指数迅速下降为6.0±2.5(P<0.05),A-aDO2,上升为(0.45±0.11)mm Hg(P<0.05)。治疗3 h、6 h、12 h、24 h的氧分压、二氧化碳分压、氧合指数、A-aDO2与对照组比较差异无统计学意义。结论 HFOV用于治疗新生儿呼吸窘迫综合征,是一种安全性好、疗效肯定的机械通气方法。
Objective To investigate the value of high frequency oscillatory ventilation in the treatment of neonatal respiratory distress syndrome. Methods A total of 62 cases of respiratory distress syndrome were divided into observation group and control group by a completely randomized design. Thirty-two patients in the observation group were treated with HFOV. Thirty patients in the control group were treated with constant-frequency mechanical ventilation and were infused with 200 mg / kg bolus of Cortisol through the endotracheal unit (supine position). Oxygen partial pressure, carbon dioxide partial pressure, alveolar-arterial oxygen pressure difference (A-aDO2) and oxygenation index were observed before and after treatment. The differences between the two groups were compared. Results After treatment with HFOV for 1 h, the oxygen partial pressure in the observation group increased significantly to (72.2 ± 12.5) mm Hg (P <0.05) and the partial pressure of carbon dioxide decreased significantly to (50.9 ± 8.9) mm Hg (P <0.01) The coincidence index decreased rapidly to 6.0 ± 2.5 (P <0.05) and A-aDO2 increased to (0.45 ± 0.11) mm Hg (P <0.05). Oxygen partial pressure, partial pressure of carbon dioxide, oxygenation index, A-aDO2 in 3 h, 6 h, 12 h and 24 h after treatment were not significantly different from those in control group. Conclusion HFOV is a safe and effective mechanical ventilation method for the treatment of neonatal respiratory distress syndrome.