高频振荡通气与常频通气治疗新生儿呼吸衰竭临床效果的对比研究

摘要

Objective To compare the clinical effect on respiratory failure between high frequency oscillatory ventilation and constant frequency ventilation in neonates. Methods A total of 100 neonates with respiratory failure were selected in the Affiliated Hospital of Inner Mongolia Medical University in 2013,and they were randomly divided into A group and B group,each of 50 cases. Based on symptomatic and supportive treatment,neonates of A group received high frequency oscillatory ventilation,while neonates of B group received constant frequency ventilation. Heart rate,mean arterial pressure, blood - gas analysis index( including PaO2 ,PaCO2 ,SaO2 and FiO2 ) before mechanical ventilation and after 6 hours of mechanical ventilation,duration of mechanical ventilation,hospital stays and in - hospital death were compared between the two groups. Results No statistically significant differences of heart rate or mean arterial pressure was found between the two groups before mechanical ventilation or after 6 hours of mechanical ventilation( P > 0. 05);after 6 hours of mechanical ventilation, heart rate of the two groups were statistically significantly lower than those before mechanical ventilation( P < 0. 05) . No statistically significant differences of PaO2 ,PaCO2 ,SaO2 or FiO2 was found between the two groups before mechanical ventilation (P > 0. 05);after 6 hours of mechanical ventilation,PaO2 and SaO2 of A group were statistically significantly higher than those of B group,while PaCO2 and FiO2 of A group were statistically significantly lower than those of B group(P < 0. 05). After 6 hours of mechanical ventilation,PaO2 and SaO2 of the two groups were statistically significantly higher than those before mechanical ventilation,while PaCO2 and FiO2 of the two groups were statistically significantly lower than those before mechanical ventilation(P < 0. 05). Duration of mechanical ventilation and hospital stays of A group were statistically significantly shorter than those of B group(P < 0. 05),while no statistically significant differences of in - hospital fatality rate was found between the two groups(P > 0. 05). Conclusion High frequency oscillatory ventilation has better clinical effect than constant frequency ventilation in treating neonates with respiratory failure,can more effectively adjust the blood - gas analysis index and shorten the duration of mechanical ventilation and hospital stays.%目的：比较高频振荡通气与常频通气治疗新生儿呼吸衰竭的临床效果。方法选取2013年内蒙古医科大学附属医院收治的呼吸衰竭患儿100例，随机分为高频振荡通气组（A 组）和常频通气组（B 组），每组50例。两组患儿入院后予以对症支持治疗，A 组患儿行高频振荡通气，B 组患儿行常频通气。比较两组患儿机械通气前、机械通气6 h 后心率、平均动脉压、血气分析指标〔动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、动脉血氧饱和度（SaO2）、吸入氧浓度（FiO2）〕及机械通气时间、住院时间、院内死亡情况。结果机械通气前、机械通气6 h后两组患儿心率、平均动脉压比较，差异均无统计学意义（P >0.05）；两组患儿机械通气6 h 后心率低于机械通气前（P <0.05）。机械通气前两组患儿 PaO2、PaCO2、SaO2、FiO2比较，差异无统计学意义（P >0.05）；机械通气6 h 后 A组患儿 PaO2、SaO2高于 B 组，PaCO2、FiO2低于 B 组（P <0.05）。两组患儿机械通气6 h 后 PaO2、SaO2高于机械通气前，PaCO2、FiO2低于机械通气前（P <0.05）。A 组患儿机械通气时间、住院时间短于 B 组（P <0.05）；两组患儿院内病死率比较，差异无统计学意义（P >0.05）。结论高频振荡通气治疗新生儿呼吸衰竭的临床效果优于常频通气，可更有效地改善患儿血气分析指标，缩短患儿机械通气时间和住院时间。