CAJ | 학술논문

目的　探讨高频通气(HFV)治疗重症呼吸窘迫综合征(RDS)的疗效。方法　20例重症RDS患儿的胎龄(33±4)周, 出生体重(2.1±0.8) kg，X线胸片示≥Ⅱ级，需机械通气(CMV)治疗。当所需吸入氧浓度(FiO2)≥0.8和(或)平均气道压(MAP)≥11 cm H2O、动脉血氧饱和度(SaO2)在2 h内仍<0.90者，改用HFV治疗。用HFV治疗者共8例。结果　8例用HFV患儿，用HFV后2 h内SaO2均≥0.90, 动脉肺泡氧分压比(a/A) 较用HFV前有显著改善( 0.08±0.01和0.18±0.06，P＜0.05), 氧合指数(OI)较用HFV前明显下降(33±11和14±4，P<0.01),FiO2 亦显著下降(0.90±0.10和0.70±0.20, P＜0.05)。至8 h FiO2 继续下降至0.60±0.20。结论　重症RDS用CMV疗效差者，改用HFV可获显效，表现为氧合改善快，短时间内 FiO2可迅速降低。
목적　탐토고빈통기(HFV)치료중증호흡군박종합정(RDS)적료효。방법　20례중증RDS환인적태령(33±4)주, 출생체중(2.1±0.8) kg，X선흉편시≥Ⅱ급，수궤계통기(CMV)치료。당소수흡입양농도(FiO2)≥0.8화(혹)평균기도압(MAP)≥11 cm H2O、동맥혈양포화도(SaO2)재2 h내잉<0.90자，개용HFV치료。용HFV치료자공8례。결과　8례용HFV환인，용HFV후2 h내SaO2균≥0.90, 동맥폐포양분압비(a/A) 교용HFV전유현저개선( 0.08±0.01화0.18±0.06，P＜0.05), 양합지수(OI)교용HFV전명현하강(33±11화14±4，P<0.01),FiO2 역현저하강(0.90±0.10화0.70±0.20, P＜0.05)。지8 h FiO2 계속하강지0.60±0.20。결론　중증RDS용CMV료효차자，개용HFV가획현효，표현위양합개선쾌，단시간내 FiO2가신속강저。
Objective　To explore the effectiveness of high frequency ventilation in the treatment of neonates with severe respiratory distress syndrome (RDS). Methods　Twenty neonates with≥ gradeⅡRDS confirmed by chest X- ray and needed conventional mechanical ventilation (CMV) treatment were enrolled in this study. Patients who failed to maintain SO2 ≥0.90 when FiO2≥0.8 and/or MAP≥11 cmH2O within 2 hours were changed to high freguency ventilation (HFV). Results　Twenty cases met the severe RDS criteria, who′s gestational age was (33±4)w and birth weight was (2.1±0.8) kg. Among them 8 cases were assigned to HFV. After 2-hour treatment, SO2 of HFV group increased to＞0.90. Arterial to alveoli oxygen ratio (a/A) improved significantly (0.08±0.01 to 0.18±0.05, P＜0.01). Oxygenation index (OI) decreased rapidly (33±11 to 14±4, P＜0.01). FiO2 decreased rapidly (0.90±0.10 and 0.70±0.20, P＜0.01). After 8 hours treatment FiO2 continually decreased to 0.60±0.18. Conclusion　The authors concluded that HFV was an effective rescue method for neonates with RDS in whom CMV failed.