CAJ | 학술논문

目的：评价同步间歇指令通气（SIMV）和高频震荡通气（HFOV）治疗新生儿呼吸窘迫综合征（NRDS）的疗效及安全性。方法符合纳入标准的NRDS患儿，随机分为SIMV组和HFOV组，记录两组血气值和呼吸机参数的变化，观察两组的临床疗效及支气管肺发育不良（BPD）、肺气漏（PAL）、Ⅲ～Ⅳ级颅内出血（IVH）、脑室周围白质软化（PVL）等并发症的发生率。结果最终完成试验SIMV组25例，HFOV组23例。 HFOV组改善氧合更明显，6、24小时HFOV组吸入氧浓度、氧合指数与SIMV组比较差异有统计学意义（P＜0．05），PaCO2、存活率差异无统计学意义（P＞0．05），两组BPD、PAL、IVH、PVL等并发症发生率比较差异均无统计学意义（P＞0．05），两组机械通气时间及住院时间比较差异有统计学意义（P＜0．05）。结论 SIMV和HFOV治疗NRDS是安全有效的，HFOV的优势是能迅速改善氧合，缩短上机时间。
목적：평개동보간헐지령통기（SIMV）화고빈진탕통기（HFOV）치료신생인호흡군박종합정（NRDS）적료효급안전성。방법부합납입표준적NRDS환인，수궤분위SIMV조화HFOV조，기록량조혈기치화호흡궤삼수적변화，관찰량조적림상료효급지기관폐발육불량（BPD）、폐기루（PAL）、Ⅲ～Ⅳ급로내출혈（IVH）、뇌실주위백질연화（PVL）등병발증적발생솔。결과최종완성시험SIMV조25례，HFOV조23례。 HFOV조개선양합경명현，6、24소시HFOV조흡입양농도、양합지수여SIMV조비교차이유통계학의의（P＜0．05），PaCO2、존활솔차이무통계학의의（P＞0．05），량조BPD、PAL、IVH、PVL등병발증발생솔비교차이균무통계학의의（P＞0．05），량조궤계통기시간급주원시간비교차이유통계학의의（P＜0．05）。결론 SIMV화HFOV치료NRDS시안전유효적，HFOV적우세시능신속개선양합，축단상궤시간。
Objective To evaluate the efficacy and safety of high frequency oscillatory ventilation (HFOV) and synchronized inter-mittent mandatory ventilation ( SIMV) in preterm infants with neonatal respiratory distress syndrome ( NRDS) requiring ventilation .Methods Preterm infants with NRDS requiring ventilation were randomly assigned to receive SIMV or HFOV .Blood gas values ,respiratory parameter , clinical efficacy,and incidence of mechanical ventilation complications such as bronchopulmonary dysplasia ( BPD),pulmonary air leakage (PAL),and serious brain injury and so on were compared between two groups .Results Twenty -three patients received HFOV and 25 SIMV.HFOV group demonstrated better early oxygenation .Significant differences were found between the two groups in oxygenation index (OI),and FiO2 at 6 and 24 hour(P<0.01).Mean PaCO2 in HFOV and SIMV group was not significantly different .No significant difference was found between the two groups in the incidences of BPD ,PAL and serious brain injury(P>0.05).The complication rate and survival rate were similar in two groups.The ventilation time and hospitalization time in SIMV were significantly longer than those in HFOV (P<0.05). Conclusion It is efficient and safe for the treatment of NRDS with HFOV or SIMV .HFOV can improve oxygenation rapidly and decrease ventilation time and hospitalization time .