冯戈平

【摘要】 目的：探讨高频振荡通气对新生儿胎粪吸入综合征（MAS）的治疗效果。方法：选取2019年1-10月笔者所在医院接治的148例MAS患儿开展此次研究，以治疗方式不同分为常规组（常频振荡通气治疗，74例）与研究组（高频振荡通气治疗，74例）。对比临床疗效。结果：研究组啰音消失时间、住院时间、氧疗时间均优于常规组，差异均有统计学意义（P<0.05）;经治疗3 d后，两组肺动脉收缩压（PASP）、肺动脉舒张压（PADP）均低于治疗前，且研究组低于常规组，差异均有统计学意义（P<0.05）;两组并发症发生率对比差异无统计学意义（P>0.05）。结论：对于新生儿胎粪吸入综合征采取高频振荡通气治疗，可有效改善患儿肺动脉高压情况，降低其肺动脉收缩压、肺动脉舒张压，影响其预后，利于患儿疾病恢复，值得推广。

【关键词】 高频振荡通气 新生儿 胎粪吸入综合征 治疗效果

doi：10.14033/j.cnki.cfmr.2020.13.054 文献标识码 B 文章编号 1674-6805（2020）13-0-03

Effect of High-frequency Oscillatory Ventilation on Neonatal Meconium Aspiration Syndrome/FENG Geping. //Chinese and Foreign Medical Research， 2020， 18（13）： -134

[Abstract] Objective： To investigate the therapeutic effect of high-frequency oscillatory ventilation on neonatal meconium aspiration syndrome （MAS）. Method： A total of 148 patients with MAS treated in our hospital from January to October 2019 were selected to conduct this study. They were divided into the routine group （constant frequency oscillatory ventilation， 74 cases） and the study group （high-frequency oscillatory ventilation， 74 cases）. The clinical efficacy of two groups was compared. Result： The time of rales disappearance， hospital stay and oxygen therapy in the study group were better than those in the routine group， the differences were statistically significant （P<0.05）. After 3 days of treatment， the two groups the pulmonary artery systolic blood pressure （PASP） and pulmonary artery diastolic blood pressure （PADP） in two groups were lower than those before treatment， and the indexes study group was lower than those in the routine group， the differences were statistically significant （P<0.05）. There was no statistically significant difference in the incidence of complications between the two groups （P>0.05）. Conclusion： High-frequency oscillatory ventilation for neonatal meconium aspiration syndrome can effectively improve the pulmonary hypertension in children， reduce its PASP and PADP， affect its prognosis， and help restore the disease status of children. It is worth promoting.

[Key words] High-frequency oscillatory ventilation Newborn Meconium aspiration syndrome Treatment effect

First-authors address： Wuhua County Peoples Hospital， Wuhua 514400， China

新生兒胎粪吸入综合征（MAS）是指孕周期过期产儿或足月儿因误吸被胎粪污染过的羊水所致的呼吸道阻塞性通气障碍。MAS主要的临床表现为呼吸窘迫，其发病机制包括误吸胎粪、排出胎粪、气道通气不均匀、肺动脉高压等，而MAS诊断先决条件主要取决于羊水中是否混合了胎粪。MAS是影响新生儿死亡的重要疾病，部分患儿出现缺氧现象，未及时治疗还易造成脑部损害，引发多种不利情况发生，临床需给予及时、积极的治疗以避免恶性情况的发生[1]。MAS会造成新生儿出现昏迷、呼吸困难及神经元代谢功能受损等严重病症，极不利于新生儿的健康成长。目前，对于新生儿MAS临床多采取机械通气、氧疗、防感染、纠正机体酸中毒等措施治疗，同时常常会给予常频振荡通气，但取得的效果并不十分如人意。……