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高频振荡通气治疗新生儿生理性支气管肺发育不良的预后
作者:刘强  尹旭凤  陈少军  陈全景  雷勋明 
单位:湖北医药学院附属东风医院 儿童医疗中心, 湖北 十堰 442000
关键词:新生儿 生理性支气管肺发育不良 机械通气 高频振荡通气 氧合指数 
分类号:R722.12
出版年·卷·期(页码):2017·36·第十一期(1558-1562)
摘要:

目的:探讨高频振荡通气治疗新生儿生理性支气管肺发育不良(BPD)的预后。方法:选择2013年8月至2016年5月在本院住院诊治的56例BPD患儿,根据随机信封抽签原则将其分为观察组与对照组,各28例。观察组给予高频振荡通气治疗,对照组给予常规持续气道正压治疗,观察与记录两组BPD预后情况。结果:观察组的氧暴露时间与机械通气时间分别为(170.14±22.19) h和(115.29±12.59) h,均明显短于对照组的(214.95±13.29) h和(138.20±17.44) h(P<0.05)。两组治疗前、治疗后48 h的PaO2与PaCO2值在组内与组间对比差异均无统计学意义(P>0.05);观察组与对照组治疗后48 h的氧合指数(OI)值分别为(10.37±2.19)和(12.49±3.19),均明显低于治疗前的(16.39±4.22)和(16.22±3.87)(P<0.05),且观察组治疗后48 h的OI值明显低于对照组(P<0.05)。观察组治疗期间肺气漏、颅内出血、肺出血等并发症发生率为7.1%,对照组为35.7%,观察组并发症发生率明显低于对照组(P<0.05)。结论:相对于常规机械通气,高频振荡通气在生理性BPD治疗中的应用能改善氧合指数,缩短氧暴露时间与机械通气时间,减少并发症的发生。

Objective:To compare the prognosis of physiological bronchopulmonary dysplasia of newborn (BPD) treated withdifferent mechanical ventilation strageties. Methods:From August 2013 to May 2016, 56 physiological BPD treated in our hospital were selected as the research object, all the newborns were divided into observation group and control group, 28 patients in each, according to the random draw envelope principle, the observation group was given high frequency oscillatory ventilation treatment, the control group was given routine treatment with continuous positive airway pressure, the prognosis of two groups were observed and recorded. Results:The oxygen exposure time and mechanical ventilation time in the observation group were(170.14±22.19) h and (115.29 ±12.59) h, respectively, being significantly less than (214.95±13.29) h and (138.20±17.44) h in the control group(P<0.05). PaO2 and PaCO2 values in the two groups were not statistically significant 48 h before and after treatment(P>0.05); The OI values 48 h after treatment in the observation group and the control group were 10.37±2.19 and 12.49±3.19, respectively, being significantly lower than those before treatment 16.39±4.22 and 16.22±3.87 (P<0.05); furthermore the OI value 48h after treatment in the observation group was significantly lower than that in the control group(P<0.05). 7.1%of the patients encountered lung leakage, intracranial hemorrhage, pulmonary hemorrhage and complication rate in the observation group during treatment, while 35.7% in the control group, the incidence of complications of in the observation group was significantly lower than that of the control group(P<0.05). Conclusion:Compared with conventional mechanical ventilation, the application of high frequency oscillatory ventilation in the treatment of physiological BPD can improve oxygenation index, shorten the oxygen exposure time and mechanical ventilation time, and reduce the incidence of complications.

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