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目的:评价高频振荡通气(HFOV)及常频通气(SIMV)在治疗新生儿重度胎粪吸入综合征(MAS)的临床效果。方法:将2011年1月至2013年12月收住茂名市妇幼保健院新生儿重症监护室的43例MAS患儿随机分成2组,其中HFOV组23例、SIMV组20例,两组分别于呼吸支持0、2、12、24、48 h时记录血氧饱和度(SaO_2)、氧分压(PaO_2)、二氧化碳分压(PaCO_2)、动脉/肺泡氧分压比值(a/APO_2),并比较两组并发症及转归情况。结果:两组患儿性别、胎龄、出生体并重、分娩方式、入院日龄比较,差异均无统计学意义(P>0.05),两组在2、12、24、48 h时PaO_2、PaCO_2、SaO_2、a//APO_2各指标相比差异有统计学意义(P<0.05),HFOV组相关肺动脉高压、气漏均低于SIMV组(P<0.05)。结论:HFOV治疗新生儿MAS的效果优于SIMV。
Objective: To evaluate the clinical effect of high frequency oscillatory ventilation (HFOV) and frequent ventilatory ventilation (SIMV) in the treatment of neonatal severe meconium aspiration syndrome (MAS). Methods: From January 2011 to December 2013, 43 cases of MAS admitted to neonatal intensive care unit of Maoming MCH hospital were randomly divided into two groups, including 23 in HFOV group and 20 in SIMV group. Respiratory support at 0, 2, 12, 24 and 48 h recorded SaO2, PaO2, PaCO2, and a / APO2 The complication and outcome of the two groups were compared. Results: There was no significant difference in gender, gestational age, birth weight, delivery mode and admission date between the two groups (P> 0.05). PaO2, PaCO2 , SaO_2 and a / APO_2 (P <0.05). The relative pulmonary hypertension and air leakage in HFOV group were lower than those in SIMV group (P <0.05). Conclusion: HFOV is superior to SIMV in neonatal MAS.