中国当代儿科杂志Issue(4)：345-349,5.DOI:10.7499/j.issn.1008-8830.2015.04.011
高频振荡通气联合肺表面活性物质治疗新生儿肺出血的疗效观察
Clinical efifcacy of high-frequency oscillatory ventilation combined with pulmonary surfactant in treatment of neonatal pulmonary hemorrhage
林新祝 1赖基栋 1吕梅 1祝垚 1王恋 1陈超2
作者信息
- 1. 厦门市妇幼保健院新生儿科，福建 厦门 361000
- 2. 上海复旦大学儿科医院新生儿科，上海 201102
- 折叠
摘要
Abstract
ObjectiveTo explore the clinical efifcacy of high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) in the treatment of neonatal pulmonary hemorrhage (NPH).MethodsA total of 122 neonates diagnosed with NPH between January 2010 and June 2014 were enrolled. After being stratiifed by gestational age, the neonates were randomly divided into treatment (HFOV+PS) and control (HFOV alone) groups (n=61 each). Both groups were treated with HFOV after the onset of NPH. After 2-4 hours of HFOV treatment, the treatment group received PS via intratracheal injections, followed by continuous use of HFOV. Dynamic changes in the blood gas, oxygenation index (OI), and PaO2/FiO2 (P/F) values of the neonates were determined before HFOV treatment and after 6, 12, and 24 hours of HFOV treatment. The time to hemostasis, duration of ventilation, incidence of complications, and cure rate were compared between groups.ResultsAfter 6, 12, and 24 hours of HFOV treatment, the treatment group had significantly improved PaO2, PaCO2, O/I, and P/F values compared with the control group (P<0.05). The time to hemostasis and the duration of ventilation were signiifcantly shorter in the treatment group than in the control group (P<0.01), and the incidence of complications was lower in the former than in the latter (P<0.05). There was no signiifcant difference in the cure rate between the treatment (87%) and control (82%) groups (P>0.05).Conclusions HFOV combined with PS is an effective treatment to improve oxygenation, shorten the time to hemostasis and the duration of ventilation, and reduce the incidence of complications in neonates with NPH. However, the dual therapy is unable to reduce the mortality of neonates compared with HFOV monotherapy.关键词
肺出血/肺表面活性物质/高频振荡通气/新生儿Key words
Pulmonary hemorrhage/Pulmonary surfactant/High-frequency oscillatory ventilation/Neonate引用本文复制引用
林新祝,赖基栋,吕梅,祝垚,王恋,陈超..高频振荡通气联合肺表面活性物质治疗新生儿肺出血的疗效观察[J].中国当代儿科杂志,2015,(4):345-349,5.
