高频震荡通气治疗重症新生儿缺氧缺血性脑病并呼吸衰竭.doc

高频震荡通气治疗重症新生儿缺氧缺血性脑病并呼吸衰竭
【摘要】目的探讨高频振荡通气在新生儿严重缺氧缺血性脑病(HIE)并呼吸衰竭的临床应用。方法 21例重症HIE并呼吸衰竭新生儿经常规机械通气(CMV) 治疗失败后改为HFOV 治疗, 治疗过程中监测经皮测氧饱和度、动脉血气及氧合指数、动脉肺泡氧分压(a/A)等。结果 21例患儿用HFOV 治疗2h后FiO2 明显下调, a/A PaO2 比值升高, 差异有统计学意义(P<); 至6h后差异有统计学意义(P<); 且未出现肺气压伤、支气管肺发育不良等后遗症。结论重症HIE用CMV无效后改用HFOV可获得显著疗效。
【关键词】新生儿缺氧缺血性脑病;呼吸衰竭;高频震荡通气
【Abstract】 Objective To evaluate the effects of high frequency oscillatory ventilation (HFOV) in the hypoxicischemic encephalopathy (HIE) with respiratory Twentyone newborns with severe HIE with respiratory failure performed the HFOV after failure of conventional mechanical ventilation (CMV). The O2 saturation, the ratio of a/A PaO2,arterial blood gas and oxygenation index were monitored in the course of The FiO2 reduced significantly after 2 hours HFOV, the ratio of a/A PaO2 increased significantly (P<), and the change was high significantly after 6 hours HFOV (P<). There was no the adverse effect of pulmonary barotraumas and bronchopulmonary HFOV is an effective method for neonatal infants with severe HIE and respiratory failure after failure of CMV.
【Key words】 Hgpoxicischemic encephalopathy;Respiratory failure;High freguency oscillatory ventilation
新生儿缺氧缺血性脑病(HIE)是严重的新生儿疾病,%,重症HIE因严重缺氧可致肺部并发症发生,如胎粪吸入综合征、持续肺动脉高压、肺出血、急性呼吸窘迫综合征等,引起严重呼吸衰竭,病死率高,常常需要机械通气。常规机械通气(conventional