黄胜奇+农定猛+吴昔林+胡秀第+刘仁颂

[摘要] 目的 探讨持续肺动脉高压新生儿接受高频振荡通气治疗的临床效果。方法 回顾分析2009年5月～2013年5月我院收治的患有持续肺动脉高压的新生儿64例，随机分为两组，每组32例，对照组实施常频机械通气、实验组实施高频振荡通气，观察两组治疗效果。结果 实验组新生儿治疗后吸入氧浓度（FiO2）及二氧化碳分压（PCO2）较治疗前明显下降（P<0.05）；经皮氧饱和度（SaO2）和氧分压（PO2）较治疗前明显升高（P<0.05）。且治疗后实验组各项指标（除pH外）均明显优于对照组（P<0.05）。实验组气胸治疗情况优于对照组（P<0.05）。两组不良反应无明显差异（P>0.05）。 结论 在新生儿持续肺动脉高压的临床治疗中，高频振荡通气效果确切，且不会导致增加颅内出血风险的几率，值得推广应用。

[关键词] 持续肺动脉高压；高频振荡通气；新生儿

[中图分类号] R722.1 [文献标识码] B [文章编号] 1673-9701（2014）17-0141-03

Clinical observation of high frequency oscillatory ventilation in treatment of persistent pulmonary hypertension of the newborn

HUANG Shengqi NONG Dingmeng WU Xilin HU Xiudi LIU Rensong

Department of Pediatrics， Liaobu Hospital of Dongguan City in Guangdong Province， Dongguan 523400， China

[Abstract] Objective To investigate clinical effect receiving high frequency oscillatory ventilation （HFOV） in the treatment of persistent pulmonary hypertension of the newborn. Methods A total of 64 cases of newborns with persistent pulmonary hypertension and forthwith from May 2009 to May 2013 in our hospital were randomly divided into two groups， 32 cases of each group. The control group was treated with normal frequency mechanical ventilation， the experimental group was treated with high frequency oscillatory ventilation. The efficacy of the two groups was compared. Results The neonatal inhaled oxygen concentration（FiO2） and carbon dioxide partial pressure （PCO2） of experimental group newborns were decreased than before treatment， there was statistical significance（P<0.05）； Former transcutaneous oxygen saturation （SaO2） and oxygen partial pressure （PO2） rose were higher than before treatment， there was statistical significance （P<0.05）. The indicators （except pH） of experimental group were better than the control group， there was statistical significance（P<0.05）. Pneumothorax treatment in the experimental group had better than the control group， there was statistical significance（P<0.05）. Two adverse reactions had no significant difference（P>0.05）. Conclusion Persistent pulmonary hypertension of the newborn clinical treatment， the exact effect of high-frequency oscillatory ventilation， and will not lead to increased risk of intracranial bleeding risk and should be widely used.

[Key words] Persistent pulmonary hypertension； High frequency oscillatory ventilation （HFOV）； Newborn

在新生儿各类危重疾病中，新生儿持续肺动脉高压（persistent pulmonary hypertension of newborn，PPHN）是其中较为常见的一种，临床又称之为持续胎儿循环。在PPHN的治疗方法中，机械通气的应用较为普遍[1]。作为近年来一种新型的机械通气方式，高频振荡通气越来越多地应用于临床呼吸疾病的治疗，其治疗原则是采用肺保护通气策略，能够在不增加气压伤的前提下，有效提高氧合，降低通气时间，降低肺气漏等并发症。本文探讨持续肺动脉高压新生儿接受高频振荡通气治疗的临床效果，现报道如下。endprint

1资料与方法

1.1一般资料

回顾分析2009年5月～2013年5月我院收治的患有持续性动脉高压的新生儿64例，其中，男38例，女26例；平均孕周（38.5±2.2）周；年龄10～42 h，平均（25.5±3.6）h；出生体重2822～3400 g，平均（3230±344）g。其中，羊水粪染13例，宫内窘迫37例；其中42例新生儿为剖宫产。本组新生儿均与新生儿持续肺动脉高压诊疗常规标准[2]相符，随机将其分为对照组和实验组各32例，两组一般资料比较差异无统计学意义（P>0.05），具有可比性。