Objective: To study the clinical effect and safety of high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) in the treatment of neonatal severe meconium aspiration syndrome (MAS) complicated by neonatal pulmonary hemorrhage (NPH).
Methods: A total of 48 children with severe MAS complicated by NPH were enrolled, and a retrospective analysis was performed for the clinical effects of HFOV+PS (trial group, 25 children) and HFOV alone (control group, 23 children). The blood gas parameters, oxygenation index (OI), PaO2/FiO2 (P/F) value, duration of pulmonary hemorrhage, ventilation time, length of hospital stay, incidence of complications, and outcome were compared between the two groups.
Results: At 6, 12, 24, and 48 hours after treatment, the trial group had significantly better PaO2, OI, and P/F value than the control group (P<0.05). Compared with the control group, the trial group had significantly shortened ventilation time and duration of pulmonary hemorrhage (P<0.05). There were no significant differences in the length of hospital stay, the incidence of complications, and cure rate between the two groups (P>0.05).
Conclusions: HFOV combined with PS can better improve oxygenation function and shorten the duration of NPH and ventilation time. Meanwhile, it does not increase the incidence of adverse events. Therefore, it is a safe and effective therapy.
目的: 探讨高频振荡通气（HFOV）联合肺表面活性物质（PS）治疗新生儿重型胎粪吸入综合征（MAS）并发肺出血（NPH）的有效性及安全性。
方法: 选取重型MAS并发NPH患儿48例，回顾性分析HFOV+PS（试验组，n=25）和单纯HFOV（对照组，n=23）治疗的临床疗效，比较两组患儿的血气分析、氧合指数（OI）、PaO2/FiO2（P/F）值、肺出血时间、呼吸机治疗时间、住院时间、并发症及转归变化。
结果: 试验组治疗后6、12、24、48h的PaO2、OI值及P/F值均要优于对照组（P < 0.05）；试验组的呼吸机治疗时间、NPH时间较对照组明显缩短（P < 0.05）；试验组住院时间、并发症和治愈率与对照组相比差异无统计学意义。
结论: HFOV联合PS能更好地改善患儿氧合功能，缩短NPH时间和呼吸机治疗时间，未增加不良反应的发生率，是安全、有效的治疗方法。