目的探讨常频机械通气(CMV)与高频振荡通气(HFOV)治疗早产儿呼吸窘迫综合征(RDS)的疗效及安全性。方法选择2013年10月至2014年10月本院新生儿重症监护室诊断为RDS且符合机械通气指征的早产儿,按照随机数字表分为CMV组和HFOV组,观察并记录两组患儿的血气分析、呼吸机参数、机械通气时间、撤机后给氧时间、临床转归与并发症。结果 HFOV组和CMV组各纳入43例,机械通气后3、12、24 h HFOV组PaO_2和PaCO_2较CMV组改善明显,3、12h HFOV组FiO_2和OI较CMV组改善明显,差异有统计学意义(P<0.05);两组各时间点pH、SaO_2及24 h FiO_2和OI差异无统计学意义(P>0.05)。HFOV组机械通气时间和撤机后总给氧时间均短于CMV组,差异有统计学意义[(75.5±18.6)h比(88.6±16.8)h,(49.9±12.5)h比(70.1±12.9)h,P<0.05]。CMV组治愈37例,死亡6例,HFOV组治愈39例,死亡4例,两组差异无统计学意义(P>0.05);两组肺气漏、Ⅲ-Ⅳ级脑室内出血、脑室周围白质软化发生率差异均无统计学意义(P>0.05)。结论 CMV与HFOV治疗新生儿RDS均有效,但HFOV在缩短机械通气时间、缩短撤机后总吸氧时间、改善氧合方面优于CMV组,同时并未增加并发症的发生率。 Objective To investigate the efficacy and safety of frequent mechanical ventilation (CMV) and high frequency oscillatory ventilation (HFOV) in the treatment of respiratory distress syndrome (RDS) in preterm infants. Methods From October 2013 to October 2014, preterm infants diagnosed as RDS in our Neonatal Intensive Care Unit and eligible for mechanical ventilation were selected and randomly divided into CMV group and HFOV group according to random number table. Two groups of children Blood gas analysis, ventilator parameters, mechanical ventilation time, oxygen time after weaning, clinical outcome and complications. Results In the HFOV group and the CMV group, 43 cases were enrolled. PaO_2 and PaCO_2 in HFOV group were significantly improved at 3, 12 and 24 hours after mechanical ventilation, while FiO_2 and OI in HFOV group were significantly improved compared with CMV group at 3 and 12 hours, the difference was statistically significant (P <0.05). There was no significant difference in pH, SaO 2, 24 h FiO 2 and OI between the two groups at each time point (P> 0.05). The duration of mechanical ventilation and the total oxygenation time in HFOV group were shorter than those in CMV group [(75.5 ± 18.6) h vs (88.6 ± 16.8) h and (49.9 ± 12.5) h vs 70.1 ± 12.9 ) h, P <0.05]. There were 37 cases cured and 6 died in CMV group, 39 cases were cured and 4 died in HFOV group (P> 0.05). There was no significant difference between the two groups in the incidence of pulmonary gas leakage, grade IV-IV intracerebral hemorrhage and periventricular leukomalacia There was no significant difference in the incidence (P> 0.05). Conclusions Both CMV and HFOV are effective in the treatment of neonatal RDS. However, HFOV is superior to CMV in shortening the duration of mechanical ventilation, shortening the time of total oxygen inhalation after weaning and improving oxygenation, while not increasing the incidence of complications.