摘要
目的研究高频振荡通气(High frequency oscillatorg ventilation,HFOV)与常频机械通气(Conventional menchanical ventilation,CMV)治疗新生儿气胸的临床疗效,寻找更适合与优越性的通气方法。方法选取新生儿病房在2013年10月~2016年2月收治的80例需要机械通气治疗的气胸新生儿。按治疗方法分为两组,观察组40例采用高频振荡通气(HFOV)治疗;对照组40例则采用常频机械通气(CMV)治疗。观察两组患儿在不同时期的血气分析指标及肺功能恢复时间,两组患儿治疗疗效与有无并发症。结果两组患儿一般资料及原发病构成比较,差异无统计学意义(P>0.05)。两组患儿在治疗前氧分压(PaO_2)、二氧化碳分压(PaCO_2)、氧合指数(OI)、动脉/肺泡氧分压(a/APO_2)的比较,差异无统计学意义(P>0.05)。两组患儿治疗4、8、12、24、48h后,观察组和对照组各时段PaO_2值均较治疗前上升(P<0.05);PaCO_2值较治疗前下降(P<0.05);OI值较治疗前明显下降(P<0.05);a/APO_2值较治疗前升高(P<0.05)。但观察组治疗4、8、12、24、48h时后PaO_2、PaCO_2、OI、a/APO_2值改善情况明显优于对照组,(P<0.05)。观察组呼吸机平均使用时间为(3.7±1.3)/d明显短于对照组的(7.1±1.8)/d(P<0.05)。观察组X线胸片恢复时间为(4.1±1.9)/d明显短于对照组的(9.5±2.3)/d(P<0.05)。治疗过程中两组患者无明显并发症情况发生(P>0.05)。结论 HFOV和CMV两种通气治疗新生儿气胸均有明显效果,但HFOV的临床治疗疗效更好,检测血气分析指标及肺功能改善更明显,且安全性更高,无明显并发症,更适合治疗新生儿气胸。
Objective To investigate the effect of HFOV and CMV in treating neonatal pneumothorax and find more suitable ventilation method. Methods80 patients with neonatal pneumothorax in our hospital from October 2013 to February 2016 were selected and divided into observation group and control group. The observation group was treated with HFOV and control group with CMV. The blood gas analysis index, lung function recovery time, treatment effect and adverse reactions were observed. Results General information and constituent ratio of primary disease of the two groups had no statistic significance （P〉0.05）. Before treatment, the difference between PaO2 , PaCO2 and OI, a/APO2 of the two groups had no statistic significance （P〉0.05）. PaO2 and a/APO2 after treatment of observation group were increased compared that before treatment （P〈0.05）. PaCO2 and OI after treatment of observation group were declined compared with that before treatment （P〈0.05）. PaO2 and a/APO2 of control group were increased compared with that before treatment. PaCO2 and OI of control group were declined compared with that before treatment. Improvement of PaO2, PaCO2, OI and a/APO2 of observation group after treatment were better than that of control group （P〈0.05）. Breathing machine average usage time of observation group [（3.7 ± 1.3）d] was obviously shorter than that of control group [（7.1±1.8）d]（P〈0.05）. X-ray chest radiograph recovery time of observation group [（4.1±1.9）d] was shorter than that of control group [（9.5±2.3）d] （P〈0.05）. No adverse reactions occurred during treatment in the two groups. Conclusion Clinical effect of HFOV is better than that of CMV, which can improve blood gas analysis index and lung function.
出处
《西部医学》
2017年第5期656-661,共6页
Medical Journal of West China
基金
陕西省医学会科研基金(2697)
