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目的:探讨早期使用高频振荡通气(High-frequency oscillatory ventilation,HFOV)能否降低孕龄30周之前早产儿支气管肺发育不良(Bronchopulmonary dysplasia,BPD)发病率。方法:将2007年9月～2010年3月玉林市第一人民医院产科孕龄30～25周早产儿在生后1 h内随机分配到高频振荡通气(HFOV)组27例或传统通气(Conventional ventilation,CV)组26例。研究其BPD发生率,病死率,病死或BPD混合发生率。结果:HFOV组婴儿BPD发生率25.9%,CV组婴儿BPD发生率38.5%(RR 0.672,95%CI 0.174～1.801,P=0.328)。HFOV组婴儿病死率14.8%,CV组婴儿病死率11.5%(RR 1.287,95%CI 0.268～6.635,P=0.725)。HFOV组婴儿病死或BPD发生率40.7%,CV组婴儿病死或BPD发生率50.0%(RR 0.814,95%CI 0.232～2.038,P=0.498)。两组婴儿病死或BPD的发生率无统计学差异。其他次要测量结果除住院时间外无统计学差异。结论:早期使用HFOV与CV在孕龄30周之前早产儿的BPD发病率等方面无统计学差异。
Objective: To investigate whether early use of high-frequency oscillatory ventilation (HFOV) can reduce the incidence of bronchopulmonary dysplasia (BPD) in preterm infants before gestational age 30 weeks. Methods: From September 2007 to March 2010, Yulin City People’s Hospital of Obstetrics and Gynecology, gestational age 30 to 25 weeks of preterm infants within 1 h after birth were randomly assigned to high-frequency oscillatory ventilation (HFOV) group of 27 patients or conventional ventilation Conventional ventilation, CV) group of 26 cases. Study their BPD incidence, mortality, death or BPD mixed incidence. Results: The incidence of BPD in infants was 25.9% in HFOV group and 38.5% in CV infants (RR 0.672, 95% CI 0.174-1.801, P = 0.328). Infant mortality was 14.8% in HFOV and 11.5% in CV (n = 128). The incidence of infant death or BPD in HFOV group was 40.7%, and the incidence of infant death or BPD in CV group was 50.0% (RR 0.814, 95% CI 0.232-2.038, P = 0.498). There was no significant difference in infant mortality or BPD between the two groups. Other secondary measurements were not statistically different except for hospital stay. Conclusions: There was no significant difference in the incidence of BPD between HFOV and CV in preterm infants before gestational age 30 weeks.