不同机械通气方式联合肺表面活性剂对新生儿急性呼吸窘迫综合征呼吸力学的影响

发布时间：2018-05-28 22:36

本文选题：高频振荡通气 + 常频机械通气　；参考：《实用医学杂志》2017年06期

【摘要】：目的:研究高频振荡通气+肺表面活性剂(HFOV+PS)、常频机械通气+肺表面活性剂(CMV+PS)、常频机械通气(CMV)治疗方式对新生儿急性呼吸窘迫综合征(ARDS)呼吸力学及疗效的影响。方法:纳入符合ARDS诊断标准的新生儿75例,HFOV+PS组25例,CMV+PS组30例,CMV组20例,前两组应用PS 70 mg/kg一次,分别检测机械通气0、12、24、48、72 h的PaO_2、PaCO_2、PaO_2/FiO_2、氧合指数(OI)、呼吸指数(RI)。结果:HFOV+PS组在机械通气12、24、48 h比较PaO_2均高于CMV+PS、CMV组,PaCO_2均低于CMV+PS、CMV组(P0.05);在机械通气12、24、48、72 h比较PaO_2/FiO_2均高于CMV+PS、CMV组,OI、RI均低于CMV+PS、CMV组(P0.05);机械通气时间、用氧时间比较均低于CMV+PS、CMV组(P0.05);3组气漏、颅内出血发生率及治愈率比较差异无统计学意义(P0.05)。结论:应用HFOV联合PS治疗新生儿ARDS可及时改善氧合功能,缩短机械通气及用氧时间,不增加并发症发生。
[Abstract]:Objective: to study the effects of high frequency oscillatory ventilation (HFOV) surfactant, normal frequency mechanical ventilation surfactant (CMV PSV) on respiratory mechanics and efficacy of ARDSs in neonates with acute respiratory distress syndrome (ARDS). Methods: a total of 75 newborns who met the diagnostic criteria of ARDS were included in the group of 25 patients with CMV PS and 30 patients with CMV group. 20 cases were treated with PS 70 mg/kg. The first two groups were treated with PS 70 mg/kg once, and PaO2 / Paco 2 / FiO2, respiratory index and respiratory index were measured respectively at 72 h after mechanical ventilation (0 1224 448 min / 72 h) in Pao 2 / P Paco 2 / P FiO 2, oxygenation index (Oi) and respiratory index (RI). Results the PaO_2 of PS group was significantly higher than that of CMV group at 1224 h after mechanical ventilation, and that of P0.05 in PS group was lower than that of P0.05 in CMV PSCMV group. The RI of OIV in PS group was higher than that of CMV group at 1224 472 h after mechanical ventilation, and the time of mechanical ventilation was lower than that of P0.05 in CMV PSS-CMV group, and the time of mechanical ventilation was lower than that of P0.05 group in CMV PSS-CMV group. There was no significant difference in the incidence and cure rate of intracranial hemorrhage (P 0.05). Conclusion: HFOV combined with PS in the treatment of neonatal ARDS can improve oxygenation function, shorten mechanical ventilation and oxygen use time, and do not increase complications.
【作者单位】：江苏大学附属医院新生儿科;
【基金】：江苏大学临床专项基金(编号:JDLCZX014)
【分类号】：R722.1

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