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目的评价高频振荡通气(HFOV)联合肺表面活性物质(PS)治疗新生儿肺出血(NPH)的安全性及有效性。方法将2011年5月至2015年6月确诊为NPH的96例新生儿随机分为HFOV组(对照组)和HFOV+PS组(治疗组),每组48例。比较两组患儿的氧合指数(OI)、病情转归及并发症发生情况。结果治疗组上机后的6、12、24 h动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、OI值、动脉/肺泡氧分压比值(a/APO2)均优于对照组(P<0.05);治疗组肺出血停止时间及氧疗时间均短于对照组(P<0.01),且呼吸机相关性肺炎(VAP)的发生率低于对照组(P<0.05)。结论 HFOV+PS不仅能够改善肺出血患儿的氧合功能,而且能够降低VAP的发生率,缩短病程,具有较好的安全性。
Objective To evaluate the safety and efficacy of high frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) in the treatment of neonatal pulmonary hemorrhage (NPH). Methods 96 neonates diagnosed with NPH from May 2011 to June 2015 were randomly divided into HFOV group (control group) and HFOV + PS group (48 cases). Oxygenation index (OI), prognosis and complication of the two groups were compared. Results PaO2, PaCO 2, OI and a / APO of 6, 12 and 24 h after treatment were significantly higher in the treatment group than those in the control group (P <0.05). The stopping time of pulmonary hemorrhage and the duration of oxygen therapy in the treatment group were shorter than those in the control group (P <0.01), and the incidence of ventilator-associated pneumonia (VAP) was lower than that in the control group ). Conclusion HFOV + PS can not only improve the oxygenation function in children with pulmonary hemorrhage, but also reduce the incidence of VAP, shorten the course of the disease and have better safety.