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为探讨高频振荡通气 (HFOV)治疗新生儿肺透明膜病 (HMD)的有效性及安全性 ,采用高频振荡通气(HFOV)治疗17例新生儿肺透明膜病 (HMD)患儿。通过调节平均气道压、振荡压力幅度、吸入氧浓度等参数以实现吸入氧浓度≤0.4时 ,经皮氧饱和度≥0.9,PaCO2 位于35～45mmHg 这个目标。治疗过程中监测心率、血压、血气及氧合指数。结果表明 :17例患儿治愈14例 ,死亡2例 ,中途放弃治疗1例。治愈患儿中 ,在施行HFOV治疗48h后平均气道压由(12.0±2.6)cmH2O降至(8.0±2.5)cmH2O(F=4.22,P<0.05) ;吸入氧浓度由0.7±0.2降至0.36±0.16(F=3.48,P<0.05) ;振荡压力幅度由(32.0±4.5)cmH2O降至(22.0±5.0)cmH2O(F=2.95,P<0.05)。用HFOV后肺部氧合得到改善 ,氧合指数由26.1±8.3降至14.2±6.9(F=2.87,P<0.05) ;治疗过程中心率、血压无明显变化 ,提示HFOV用于治疗新生儿HMD是一种安全有效的机械通气方法 ,对心血管无明显副作用
To investigate the effectiveness and safety of high frequency oscillatory ventilation (HFOV) in the treatment of neonatal hyaline membrane disease (HMD), 17 neonates with hyaline membrane disease (HMD) were treated with high frequency oscillatory ventilation (HFOV). By adjusting the average airway pressure, oscillation pressure amplitude, inhaled oxygen concentration and other parameters in order to achieve inhaled oxygen concentration ≤ 0.4, the percutaneous oxygen saturation ≥ 0.9, PaCO2 at 35 ~ 45mmHg this goal. Heart rate, blood pressure, blood gas and oxygenation index were monitored during treatment. The results showed that: 17 cases of children were cured in 14 cases, 2 patients died, giving up treatment in 1 case. In the cured children, mean airway pressure decreased from (12.0 ± 2.6) cmH2O to (8.0 ± 2.5) cmH2O (F = 4.22, P <0.05) 48 h after HFOV treatment, and the inhaled oxygen concentration decreased from 0.7 ± 0.2 to 0.36 ± 0.16 (F = 3.48, P <0.05). The amplitude of oscillation pressure decreased from (32.0 ± 4.5) cmH2O to (22.0 ± 5.0) cmH2O (F = 2.95, P <0.05). Lung oxygenation improved with HFOV from 26.1 ± 8.3 to 14.2 ± 6.9 (F = 2.87, P <0.05). There was no significant change in heart rate and blood pressure during HFOV, suggesting that HFOV was used to treat neonatal HMD Is a safe and effective method of mechanical ventilation, no significant side effects on the cardiovascular