论文部分内容阅读
目的 探讨高频通气 (HFV)治疗重症呼吸窘迫综合征 (RDS)的疗效。方法 2 0例重症RDS患儿的胎龄 (33± 4)周 ,出生体重 (2 1± 0 8)kg ,X线胸片示≥Ⅱ级 ,需机械通气 (CMV)治疗。当所需吸入氧浓度 (FiO2 )≥ 0 8和 (或 )平均气道压 (MAP)≥ 11cmH2 O、动脉血氧饱和度 (SaO2 )在 2h内仍 <0 90者 ,改用HFV治疗。用HFV治疗者共 8例。结果 8例用HFV患儿 ,用HFV后 2h内SaO2均≥ 0 90 ,动脉肺泡氧分压比 (a/A)较用HFV前有显著改善 (0 0 8± 0 0 1和 0 18± 0 0 6 ,P <0 0 5 ) ,氧合指数 (OI)较用HFV前明显下降 (33± 11和 14± 4,P <0 0 1) ,FiO2 亦显著下降 (0 90± 0 10和 0 70± 0 2 0 ,P <0 0 5 )。至 8hFiO2 继续下降至 0 6 0± 0 2 0。结论 重症RDS用CMV疗效差者 ,改用HFV可获显效 ,表现为氧合改善快 ,短时间内FiO2 可迅速降低。
Objective To investigate the efficacy of high frequency ventilation (HFV) in the treatment of severe respiratory distress syndrome (RDS). Methods Twenty children with severe RDS were enrolled in this study. The gestational age (33 ± 4) weeks, birth weight (21 ± 0 8) kg and X - ray showed grade Ⅱ, requiring mechanical ventilation (CMV). HFV was used when the required oxygen concentration (FiO2) ≥0 8 and / or mean airway pressure (MAP) ≥11 cmH2O, arterial oxygen saturation (SaO2) <0 90 within 2 h. A total of 8 patients treated with HFV. Results In 8 HFV children, SaO2 was both 0 90% within 2 h after HFV, and a / A was significantly improved compared with before HFV (0 0 8 ± 0 0 1 and 0 18 ± 0 (P <0.01), FiO2 also decreased significantly (0 90 ± 0 10 and 0 0, P 0 05), oxygen index (OI) decreased significantly compared with that before HFV (33 ± 11 and 14 ± 4, 70 ± 0 2 0, P <0 0 5). To 8hFiO2 continued to decline to 0 6 0 ± 0 2 0. Conclusion Severe RDS with poor curative effect of CMV, use HFV can be markedly improved, showed rapid improvement of oxygenation, FiO2 can be rapidly reduced in a short period of time.