摘要目的：探讨高频振荡通气（HFOV)联合吸入一氧化氮（iNO)治疗新生儿难治性呼吸衰竭的临床疗效.方法选择我院出生并入住新生儿重症监护病房诊断为难治性呼吸衰竭的新生儿，随机分为观察组和对照组，观察组应用 HFOV 联合 iNO 治疗，对照组应用 HFOV 治疗.观察两组患儿治疗前及治疗后1、12、24、48 h 血气、吸入氧浓度（FiO2)等指标的变化及并发症发生情况.结果共纳入85例患儿，观察组44例，对照组41例.两组患儿性别、胎龄、出生体重、原发病等比较差异均无统计学意义（P >0.05).治疗前两组 PaO2、PaCO2、FiO2差异均无统计学意义（P >0.05).治疗后24 h 观察组 PaO2高于对照组[（67.2±7.6)mmHg 比（47.1±5.2)mmHg]，PaCO2和 FiO2低于对照组[（40.3±7.6) mmHg 比（57.1±5.4) mmHg，（46±14)%比（55±13)%，P <0.05]；治疗后48 h 观察组 PaO2、PaCO2、FiO2亦均优于对照组，差异有统计学意义（P <0.05).观察组呼吸机使用时间短于对照组，病死率低于对照组[（120.4±16.2)h 比（148.9±19.3)h，6.8%比26.8%，P <0.05].两组并发症发生率差异无统计学意义（P >0.05).结论 HFOV 联合 iNO治疗新生儿难治性呼吸衰竭疗效显著，可显著改善氧合，提高患儿存活率.患儿短时间、低剂量iNO 治疗未发生严重不良反应.

abstractsObjective To study the c1inica1 effect of high frequency osci11atory venti1ation (HFOV) in conjunction with inha1ed nitric oxide ( iNO) in the treatment of neonata1 refractory respiratory fai1ure. Methods Neonates who were born in our Hospita1 and diagnosed as refractory respiratory fai1ure in our neonata1 intensive care unit were random1y assigned into the observation group and the contro1 group. Neonates in the observation group were treated with HFOV + iNO, and neonates in the contro1 group were treated with HFOV. B1ood gas ana1ysis, inha1ed oxygen concentration (FiO2 ) and other indicators before treatment and 1, 12, 24 and 48 h after treatment were co11ected. The comp1ications of two groups a1so were observed. Results There were 85 cases, 44 in the observation group and 41 in the contro1 group. There were no statistica11y significant differences between two groups in gender, gestationa1 age, birth weight and the primary disease (P > 0. 05). No statistica11y significant differences were found between two groups in PaO2 , PaCO2 and FiO2 before treatment (P > 0. 05). 24 h after treatment, PaO2 of the observation group was higher than that of the contro1 group, PaCO2 and FiO2&nbsp;of the observation group were 1ower than that of the contro1 group [(67. 2 ± 7. 6) mmHg vs. (47. 1 ± 5. 2) mmHg, (40. 3 ± 7. 6) mmHg vs. (57. 1 ± 5. 4) mmHg, (46 ± 14)% vs. (55 ± 13)% , P <0. 05]. 48 h after treatment, PaO2 , PaCO2 and FiO2 in the observation group were a1so better than those in the contro1 group (P < 0. 05). The duration of venti1ator therapy in the observation group was shorter than that in the contro1 group [(120. 4 ± 16. 2) h vs. (148. 9 ± 19. 3) h, (P < 0. 05)]; the morta1ity of the observation group (6. 8% ) was 1ower than that of the contro1 group (26. 8% ), ( P < 0. 05) . However, the differences of the incidence of comp1ications between two groups showed no significance (P> 0. 05). Conclusions Combined HFOV with iNO is significant1y effective in the treatment of neonata1 refractory respiratory fai1ure. This kind of combination therapy cou1d significant1y improve oxygenation and surviva1 rate of these patients. There are no serious adverse reactions in neonates with short time and 1ow doses of iNO treatment.