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目的探讨高频振荡通气(HFOV)治疗重症新生儿呼吸窘迫综合征(RDS)的临床效果。方法 40例重症RDS患儿采用HFOV治疗作为观察组,40例重症RDS患儿采用常频机械通气治疗作为对照组。比较两组患儿肺功能、并发症、机械通气时间及住院时间。结果机械通气治疗后1 h,观察组患儿吸入氧浓度(Fi O2)、平均气道压(MAP)、氧合指数(OI)、动脉血二氧化碳分压(Pa CO2)均得到改善,与治疗前相比差异有统计学意义(P<0.05),对照组患儿Fi O2、MAP、Pa CO2无明显改善,与治疗前比较差异无统计学意义(P>0.05);机械通气治疗后6 h,两组各观察指标均较治疗前明显改善,但观察组Fi O2、MAP、OI、Pa CO2较对照组改善更明显,比较差异有统计学意义(P<0.05);机械通气治疗24 h后,观察组OI、MAP明显低于对照组,差异有统计学意义(P<0.05)。观察组治愈率、死亡率均优于对照组,差异有统计学意义(P<0.05)。两组合并气漏发生率比较差异有统计学意义(P<0.05);观察组患儿机械通气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论 HFOV能更好更快的改善重症RDS患儿的肺氧合功能,缩短病程,减少并发症发生率。
Objective To investigate the clinical effect of high frequency oscillatory ventilation (HFOV) on severe neonatal respiratory distress syndrome (RDS). Methods 40 cases of severe RDS children treated with HFOV as the observation group, 40 cases of severe RDS children treated with mechanical ventilation as the control group. The lung function, complications, duration of mechanical ventilation and hospital stay in both groups were compared. Results At 1 h after mechanical ventilation, FiO2, MAP, OI and Pa CO2 were all improved in the observation group, (P <0.05). There was no significant difference in Fi O2, MAP and Pa CO2 between the two groups (P> 0.05), and no significant difference between before and after treatment (P0.05) .After 24 hours of mechanical ventilation, the scores of Fi O2, MAP, OI and PaCO 2 in the observation group improved more obviously than those in the control group , The observation group OI, MAP was significantly lower than the control group, the difference was statistically significant (P <0.05). The cure rate and death rate in the observation group were better than those in the control group, with statistical significance (P <0.05). There was significant difference between the two groups in the incidence of combined air leak (P <0.05). The mechanical ventilation time and hospital stay in the observation group were shorter than those in the control group (P <0.05). Conclusion HFOV can improve the pulmonary oxygenation function, shorten the course and reduce the complication rate in children with severe RDS better and faster.