目的 探讨早期高频振荡通气(HFOV)在新生儿呼吸窘迫综合征治疗中的应用价值及安全性.方法 采用完全随机设计方法,将50例呼吸窘迫综合征早产儿分为观察组与对照组.观察组27例采用HFOV治疗,对照组23例采用常频机械通气并经气管导管单体位(仰卧位)一次性快速滴注猪肺磷脂注射液200 ms/kg.观察2组治疗前后动脉血氧分压、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2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(71.2±13.6)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5.9±2.6(P< 0.05),A-aDO2上升为(0.44±0.12)mm Hg(P<0.05).治疗3、6、12、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早期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 study the effect of high-frequency oscillatory ventilation for newborn infants with neonatal respiratory distress syndrome. Methods Infants with neonatal hyaline membrane disease were divided into 2 groups: 27 cases(group A) were treated with high-frequency oscillatory ventilation and 23 cases (group B) were treated with conventional mechanical ventilation. Meanwhile PS (200 mg/kg) was dropped into the intracheal tube at the beginning group B. Results PaCO2, OI obviously decreased (PaCO2: (50.9±8.9)mm Hg, OI:5.9±2.6) and PaO2, A-aDO2, increased [PaO2±(71.2±13.6)mm Hg, A-aDO2: (0.44±0.12)mm Hg] in group B after therapy (P <0.01, P < 0.05). There was no significant difference in the PaO2, PaCO2, OI, A-aDO2 between the two groups on 3,6, 12, 24 hours after therapy. Conclusion HFOV can significantly improve pulmonary gas exchange in NRDS patients and reduce the mechanical ventilation and hospitalization time.
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