目的 比较容量目标通气（volume-target ventilation，VTV）与高频振荡通气（high-frequency oscillatory ventilation，HFOV）治疗新生儿呼吸窘迫综合征（neonatal respiratory distress syndrome，NRDS）的治疗效果。 方法 回顾性队列分析2016年9月—2022年2月收治的140例重度NRDS患儿临床资料，其中VTV组55例，HFOV组85例。VTV组采用常频机械通气+目标潮气量，HFOV组采用HFOV模式。收集患儿入院后48 h动脉血气分析结果，记录并比较患儿住院期间病死率、有创机械通气时间、氧疗时间，以及并发症的发生率。 结果 HFOV组患儿Ⅲ~Ⅳ级脑室周围-脑室内出血和新生儿坏死性小肠结肠炎的发生率低于VTV组（P<0.05）；而两组患儿有创机械通气时间、氧疗时间、病死率，以及支气管肺发育不良、低碳酸血症、高碳酸血症、脑室周围白质软化、早产儿视网膜病变的发生率比较，差异无统计学意义（P>0.05）。 结论 HFOV治疗NRDS的疗效优于VTV。
Abstract
Objective To study the clinical efficacy of volume-targeted ventilation (VTV) versus high-frequency oscillatory ventilation (HFOV) in the treatment of neonatal respiratory distress syndrome (NRDS). Methods A retrospective cohort analysis was performed on the medical data of 140 neonates with severe NRDS who were admitted from September 2016 to February 2022, with 55 neonates in the VTV group and 85 in the HFOV group. The neonates in the VTV group received conventional mechanical ventilation and target tidal volume, and those in the HFOV group received HFOV. Arterial blood gas parameters were collected at 48 hours after admission, and related indices during hospitalization were recorded, including mortality rate, duration of invasive mechanical ventilation, duration of oxygen therapy, and the incidence rates of complications. Results Compared with the VTV group, the HFOV group had significantly lower incidence rates of grade Ⅲ-Ⅳ periventricular-intraventricular hemorrhage and neonatal necrotizing enterocolitis (P<0.05), and there were no significant differences between the two groups in the duration of invasive mechanical ventilation, the duration of oxygen therapy, mortality rate, and the incidence rates of bronchopulmonary dysplasia, hypocapnia, hypercapnia, periventricular leukomalacia, and retinopathy of prematurity (P>0.05). Conclusions HFOV has a better clinical efficacy than VTV in the treatment of NRDS.
关键词
新生儿呼吸窘迫综合征 /
容量目标通气 /
高频振荡通气 /
新生儿
Key words
Neonatal respiratory distress syndrome /
Volume-targeted ventilation /
High-frequency oscillatory ventilation /
Neonate
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