关键词: 早产儿, 呼吸窘迫综合征, 肺表面活性物质, 高频振荡通气

Abstract: Objective To analyze the effects of different ventilation methods during pulmonary surfactant(PS) administration on the treatment of severe neonatal respiratory distress syndrome(RDS),in order to provide reference for the treatment of RDS. Methods A total of 65 preterm infants who met the inclusion criteria were enrolled in this study,and were divided into manual ventilation group(n=32) and high frequency ventilation group(n=33).The changes of percutaneous partial pressure of O₂(tcPO₂) and CO₂(tcPCO₂₎,oxygenation index(OI)and respiratory index(RI) during PS administration were retrospectively analyzed,and the chest X-ray situation,mechanical ventilation time and related complications were also compared. Results During administration,tcPO₂ transiently decreased and tcPCO₂ increased.After administration,tcPO₂ rapidly increased,tcPCO₂ decreased in both groups.The changes of manual ventilation group were more obvious and had longer duration time(P＜0.05).Also,tcPO₂ and tcPCO₂ reached steady till 5 minutes to 15 minutes after PS administration,the high frequency ventilation group was earlier than the manual ventilation group(P＜0.05).At 1 hour,the high frequency ventilation group had lower OI and RI than the manual ventilation group(P＜0.05).The high frequency ventilation group had more conspicuous improvement of X-ray,shorter duration of mechanical ventilation than the manual ventilation group(P＜0.05).There were no significant differences on the complication incidence (intraventricular hemorrhage,bronchopulmonary dysplasia,air leak syndrome) (P＞0.05) between the two groups. Conclusion High frequency oscillatory ventilation during endotracheal PS injection can significantly reduce tcPO₂,tcPCO₂ fluctuation,and improve the neonatal pulmonary compliance and oxygenation in severe RDS neonates more effectively,thereby shortening the duration time for mechanical ventilation.

Key words: preterm infants, respiratory distress syndrome, pulmonary surfactant, high frequency oscillatory ventilation