高频振荡通气在新生儿肺出血中的应用.DOCVIP

临床医学论文-高频振荡通气在新生儿肺出血中的应用 ???????????????????? 作者：赵少岚，陈丽珊，林泽鹏 【关键词】? 高频振荡通气;常规机械通气;肺出血；新生儿 　　摘要：目的:观察高频振荡通气(HFOV)治疗新生儿肺出血的疗效。方法:将24例新生儿肺出血患儿随机分为治疗组(ｎ=12)和对照组(ｎ=12),治疗组采用HFOV治疗,对照组采用常规机械通气(CMV)治疗,比较两组患儿的呼吸机参数和氧合指标情况。结果:两组病死率无明显差异，HFOV治疗6～24ｈ后,氧合指数明显下降且低于CMV对照组,两组比较差异有显著性(Ｐ0.05);存活患儿的肺出血停止时间、撒机时间比对照组短,差异有显著性(Ｐ0.05)。结论: HFOV对新生儿肺出血能更好改善氧合,减少气道伤, 缩短病程,其疗效及安全性是肯定的。 　　关键词：高频振荡通气;常规机械通气;肺出血；新生儿 　　High Frequency Oscillatory Ventilation in Neonates with Pulmonary Hemorrhage 　　Abstract：Objective: To investigate and evaluate the application and safety of high frequency oscillatory ventilation (HFOV) in the treatment of neonates with pulmonary hemorrhage. Method：The neonates with pulmonary hemorrhage randomly divided into two groups, treatmentd group(n=12) and compared group(n=12); The treatmentd group was treated with HFOV, and the compared group was treated with conventional mechanical ventilation (CMV). Changes of oxygen and respiratory ventilation parameters were observed in 24 hours before and after the therapy. Result: Theres no difference between two groups in neonates mortality; The changes of oxygen parameters in the treatmented group(HFOV) were? distinctly lower than the compared group (CMV); Theres significant difference between two groups(Ｐ0.05). Theres significant difference between two groups(Ｐ0.05) in the surviving neonates compared with other parameters( the time of pulmonary hemorrhage and the time of ventilation). Conclusion: Compared? HFOV and CMV treatment in neonates with pulmonary hemorrhage, the former is better in ventilation effect and oxygenation improvment, and also more safely and effective. 　　Key words:High frequency ventilation；Conventional mechanical ventilation；Pulmonary hemorrhage；Neonate 　　肺出血是许多新生儿危重疾病的晚期表现，病死率极高。机械通气加支气管内注入药物灌洗治疗是目前主要的治疗方法。传统CMV通气往往存在低通气压力不足以缓解肺血氧合状况、高通气压力又易导致肺组织气压伤的矛盾，故此,采用低潮气量的高频通气(ＨFV)研究日益受到重视,特别是高频震荡通气(HFOV)。高频振荡通气(HFOV)是近年出现的一种新型机械通气方式, 目前对新生儿呼吸窘迫综合征的治疗效果是肯定的。为探讨该法用于新生儿肺出血治疗的有效性及临床价值，我科3年来对24例新生儿肺出血进行临床对照研究，现报道如下： 　　1资料