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目的 探讨高频振荡呼吸机在治疗新生儿呼吸衰竭中的应用价值及其安全性。方法 2 8例新生儿呼吸衰竭患儿经常频呼吸机治疗无效后改用高频振荡呼吸机治疗 ,观察其治疗前后血气指标的变化及临床疗效。结果 2 8例患儿中治愈 2 0例 ,治愈率 71 4% ,死亡 5例 ,放弃治疗 3例 ;出现颅内出血等并发症 6例 ;治愈患儿中高频振荡通气 (HFOV)治疗后 8～ 12h的PaCO2 迅速下降 [(6 8± 0 4)kPavs(5 5± 0 6 )kPa,P <0 0 5 ],2 4～ 48h的PaO2 明显上升 [(5 8± 1 1)kPavs(9 2± 1 7)kPa ,P <0 0 5 ];同时吸入氧浓度、平均气道压、振荡压力幅度、血氧合指数等均有明显下降 (P均 <0 0 5 )。结论 HFOV用于治疗新生儿呼吸衰竭 ,是一种疗效肯定、安全性好的新型机械通气方法 ,具有常频机械通气 (CMV)难以比拟的优越性。
Objective To explore the value and safety of high-frequency oscillating ventilator in the treatment of neonatal respiratory failure. Methods Twenty-eight neonates with respiratory failure were treated with high-frequency oscillating ventilator after frequent ventilator resuscitation. Changes of blood gas index and clinical efficacy were observed before and after treatment. Results Twenty-eight cases were cured in 20 cases, the cure rate was 71.4%, 5 died and 3 cases were abandoned. Complications such as intracranial hemorrhage occurred in 6 cases. After treatment of high-frequency oscillatory ventilation (HFOV) PaCO2 decreased rapidly at 12h [(6 8 ± 0 4) kPavs (5 5 ± 0 6) kPa, P 0 05) and PaO2 increased significantly at 2 4 ~ 48 h [(5 8 ± 1 1) kPavs ± 1 7) kPa, P <0 0 5]. At the same time, inhaled oxygen concentration, mean airway pressure, oscillation pressure amplitude and oxygenation index decreased significantly (all P <0.05). Conclusion HFOV is a new type of mechanical ventilation method with positive curative effect and good safety for the treatment of neonatal respiratory failure. It has the incomparable superiority of CMV.