摘要
目的探究无创高频机械通气对新生儿呼吸衰竭(NRF)患儿肺氧合能力、二氧化碳(CO2)潴留和酸中毒的影响。方法回顾性分析我院经无创高频震荡通气(HFOV)治疗(nHFOV组)及经常频机械通气(CMV)治疗(CMV组)各62例NRF患儿的临床资料。记录2组临床疗效、治疗期间并发症发生情况[气压伤、颅内出血、肺气漏、气胸、呼吸机相关肺炎(VAP)]及存活患儿治疗时间(机械通气时间、氧疗时间、总住院时间),并比较2组治疗前(T0)、治疗后12 h(T1)、治疗后24 h(T2)血气分析指标[动脉血氧分压p(O2)、动脉血二氧化碳分压p(CO2)、酸碱度(pH)]、呼吸功能指标[氧合指数(OI)、吸入氧分数(FiO2)、平均气道压(MAP)]差异。结果nHFOV组临床疗效明显优于CMV组(P<0.05)。nHFOV组存活患儿机械通气时间、氧疗时间、总住院时间均明显低于CMV组(P<0.05)。2组各时间点p(O2)、pH比较均为T0<T1<T2(P<0.05),p(CO2)水平及呼吸功能指标(OI、FiO2、MAP)比较则为T0>T1>T2(P<0.05);且T1及T2时,nHFOV组p(O2)、pH水平均高于CMV组(P<0.05),p(CO2)水平及OI、FiO2、MAP水平则低于CMV组(P<0.05)。nHFOV组气压伤和VAP发生率明显低于CMV组(P<0.05);2组颅内出血、肺气漏、气胸发生率差异无统计学意义。结论nHFOV治疗NRF效果较好,可提高患儿肺氧合功能,并纠正CO2潴留、酸中毒状态,且避免发生气压伤,有利于患儿病情恢复。
Objective To explore the effects of nasal high-frequency oscillation ventilation(HFOV)on pulmonary oxygenation capacity,carbon dioxide(CO2)retention and acidosis in children with neonatal respiratory failure(NRF).Methods The clinical data of 62 child patients with NRF who underwent nasal HFOV(nHFOV group)and conventional mechanical ventilation(CMV group)were retrospectively analyzed.The clinical efficacy,occurrence of complications during treatment[barotrauma,intracranial hemorrhage,lung air leaks,pneumothorax,ventilator associated pneumonia(VAP)]and treatment time of surviving patients(mechanical ventilation time,oxygen therapy time,total hospital stay)were recorded in the two groups.The blood gas analysis indicators[arterial partial pressure of blood oxygen p(O2),arterial partial pressure of blood carbon dioxide p(CO2),pH value]and respiratory function indicators[oxygenation index(OI),fraction of inspiration oxygen(FiO2),mean airway pressure(MAP)]were compared before treatment(T0),at 12 h after treatment(T1)and at 24 h after treatment(T2)between the two groups.Results The clinical efficacy was significantly better in nHFOV group than that in CMV group(P<0.05).There were no significant differences in the occurrence of intracranial hemorrhage,pulmonary air leaks and pneumothorax between the two groups(P>0.05).The incidence rates of barotrauma and VAP and the mechanical ventilation time,oxygen therapy time and total hospital stay of surviving patients were significantly lower in nHFOV group than those in CMV group(P<0.05).The blood gas analysis indicators[p(O2)and pH]in the two groups at each time point showed those at T0<at T1<at T2(P<0.05),and the comparison of p(CO2)level and respiratory function indicators(OI,FiO2 and MAP)showed those at T0>at T1>at T2(P<0.05).And at T1 and T2,the p(O2)and pH levels were significantly higher in nHFOV group than those in CMV group(P<0.05),and the p(CO2)level and OI,FiO2 and MAP levels were significantly lower than those in CMV group(P<0.05).Conclusion nHFOV has good effects in the treatment of NRF,and it can improve the pulmonary oxygenation function,correct the states of CO2 retention and acidosis,and avoid the occurrence of barotrauma.And it is beneficial to the disease recovery.
作者
王晓芳
刘玲
WANG Xiao-fang;LIU Ling(Department of Neonatology,Xinxiang 453000,Henan,China;Department of Clinical Laboratory,Xinxiang Central Hospital,Xinxiang 453000,Henan,China)
出处
《天津医药》
CAS
北大核心
2019年第11期1161-1165,共5页
Tianjin Medical Journal
关键词
新生儿呼吸衰竭
无创高频机械通气
常频机械通气
酸中毒
neonatal respiratory failure
nasal high-frequency oscillation ventilation
conventional mechanical ventilation
acidosis
