| Objective:To investigate the clinical significance of high frequency oscillatory ventilation?HFOV?combined with inhaled nitric oxide?i NO?in the treatment of neonatal refractory hypoxic respiratory failure.Methods:Children with refractory hypoxic respiratory failure who were admitted to the neonatal department of anqing hospital affiliated to anhui medical university from August 1,2017 to January 1,2020 were selected as the research objects.Inclusion criteria:?1?Newborns from birth to 28 days after birth with gestational age of>34 weeks and weight of>1500g;?2?After 24 hours of treatment,the effect of Conventional Mechanical Ventilation?CMV?is not good,and there are still children with refractory hypoxic respiratory failure;Among them,children with CMV combined with i NO were taken as the control group?16 cases,male:8 cases;female:8cases?,children with HFOV combined with i NO as the experimental group?16 cases,male:10cases;female:6cases?.Dynamic monitoring:?1?Changes of Fraction of Inpired Oxygen?Fi O2?,Percutaneous Oxygen Saturation?Sp O2?,Arterial Oxygen Partial Pressure?Pa O2?,Arterial Partial Pressure of Carbon Dioxide?Pa CO2?,PH,Lactic acid and respiratory function:Oxygenation Index?OI?,Pa O2/Fi O2before treatment,2 hours after treatment and 24hours after treatment.?2?The duration of ventilator use and the duration of i NO use in two groups of children were counted.SPSS21.0 software was used for statistical analysis of the data studied in both groups.The comparison of measurement data was all conducted by t test,expressed as mean valueħstandard deviation?ħs?,and the comparison of counting data was conducted F test,in both tests,bilateral P<0.05 was considered statistically significant.Result:?1?The gender,day age and birth weight of the two groups were normally distributed data,which were described in the form of median and compared by the non-parametric rank-sum test.The results showed that the comparison in gender,age and birth weight between the two groups were all P>0.05.the data of the children's day age,gender and birth weight were comparable,that is,the children's day age,gender and birth weight did not affect the results of the comparison between the two groups of experimental data.?2?In the experimental group?HFOV combined with i NO treatment?and the control group?CMV combined with i NO treatment?,all measurement data were expressed as meanħstandard deviation?ħs?,and t test was used to compare the two groups.The results of data comparison showed that:?1?Pa O2was significantly higher and Pa CO2was significantly lower in HFOV combined with i NO than in CMV combined with i NO after 2 hours and 24 hours,all P<0.05,and the difference was statistically significant;however the data on PH and Lac show that,all P>0.05,and the difference was not statistically significant;?2?After 2 hours and 24 hours of HFOV combined with i NO treatment,the children in the experimental group were significantly lower than those in the control group,however,OI and Pa O2/Fi O2were significantly higher than those in the control group,all P>0.05,and the difference was statistically significant.?3?The duration of ventilator use and i NO use in the experimental group were significantly shorter than those in the control group,both P>0.05,and the difference was statistically significant.?3??1?Blood gas indexes of the control group were analyzed after 2 hours and 24 hours of CMV treatment and CMV combined i NO treatment respectively,all P<0.05,and the difference was statistically significant;?2?the blood gas indexes of children in the experimental group were analyzed after 2 hours of CMV treatment and 24 hours of HFOV combined with i NO treatment respectively,all P<0.05,and the difference was statistically significant.Conclusion:?1?HFOV combined with i NO treatment can significantly improve the oxygenation status and respiratory function of children.?2?HFOV combined with i NO treatment can also significantly shorten the duration of ventilator use and the duration of i NO use in children. |
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