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目的:研究机械通气治疗新生儿肺出血的临床疗效。方法:将23例肺出血新生儿分组采用常频机械通气(CMV)、高频震荡通气(HFOV)呼吸机模式治疗,CMV组(n=13例)采用常频机械通气治疗,HFOV组(n=10例)采用高频震荡通气治疗,比较两组患儿上机后1、4、8、24、48 h的血气和肺氧合功能监测指标以及病情转归。结果:采用机械通气治疗新生儿肺出血总病死率39.1%。HFOV组病死率、并发症发生率低于CMV组(P<0.05),上机后1、4、8、24h的HFOV组低氧血症、高碳酸血症的纠正和肺氧合功能的改善均快于CMV组,两组比较差异有统计学意义(P<0.05);HFOV组平均肺出血停止时间、上呼吸机时间、住院时间均少于CMV组,两组比较差异有统计学意义(P<0.05)。结论:采用机械通气治疗新生儿肺出血有较好的疗效。HFOV能更快纠正低氧血症、高碳酸血症,更好改善肺氧合功能,缩短病程,减少并发症的发生,降低死亡率。
Objective: To study the clinical effect of mechanical ventilation on neonatal pulmonary hemorrhage. Methods: Twenty-three newborn infants with pulmonary hemorrhage were treated by CMV and HFOV. CMV group (n = 13) was treated by conventional mechanical ventilation. HFOV group (n = 10 cases) were treated by high-frequency oscillatory ventilation. The monitoring indexes of blood gas and pulmonary oxygenation and the prognosis of the patients in the two groups were compared at 1, 4, 8, 24, and 48 h after operation. Results: The total mortality of neonatal pulmonary hemorrhage treated with mechanical ventilation was 39.1%. In the HFOV group, the mortality and complication rate were lower than those in the CMV group (P <0.05). Hypoxemia, hypercapnia and pulmonary oxygen function were improved in the HFOV group at 1,4,8 and 24 hours (P <0.05). The average pulmonary hemorrhage stop time, ventilator time and hospital stay in HFOV group were less than those in CMV group, the difference was statistically significant (P <0.05) P <0.05). Conclusion: The mechanical ventilation for neonatal pulmonary hemorrhage has a good effect. HFOV can be more quickly correct hypoxemia, hypercapnia, better lung oxygenation function, shorten the course of the disease, reduce the incidence of complications and reduce mortality.