鼻塞式同步间歇指令通气联合肺表面活性物质治疗新生儿肺透明膜病的临床疗效

发布时间：2018-06-29 11:04

本文选题：新生儿肺透明膜病 + 肺表面活性物质　；参考：《山东医药》2017年33期

【摘要】：目的探讨鼻塞式同步间歇指令通气(n SIMV)联合肺表面活性物质(PS)治疗新生儿肺透明膜病(NHMD)的疗效及对患儿呼吸功能的影响。方法选取NHMD患儿96例,随机分为A、B组各48例。A组予以n SIMV联合PS治疗,B组予以与鼻塞式持续气道正压通气(n CPAP)联合PS治疗。比较两组患儿治疗前、治疗3 d呼吸力学指标静态肺顺应性(Cstat)、吸气峰流量(Insp Flow)、呼吸时间常数和血气指标p H、Pa CO2、Pa O2、Sp O2变化,记录两组PS用量及呼吸机通气时间、插管上机率以及并发症发生情况。结果与治疗前比较,治疗3 d两组Cstat、Insp Flow、Pa O2、Sp O2均升高,Pa CO2降低(P均0.05);治疗3 d,A组Cstat、Insp Flow、Pa O2、Sp O2水平均高于B组,Pa CO2低于B组(P均0.05)。A组呼吸机通气时间少于B组(P0.05)。A、B组总有效率分别为93.75%、79.17%,插管上机率为14.58%、35.42%,并发症发生率为33.33%、72.92%,两组比较差异均有统计学意义(P均0.05)。结论 n SIMV联合PS治疗NHMD能显著改善患儿呼吸力学和血气指标,临床疗效较好,可作为NHMD治疗的首选方法。
[Abstract]:Objective to investigate the effect of nasal stuffy intermittent mandatory ventilation (n SIMV) combined with pulmonary surfactant (PS) in the treatment of neonatal hyaline membrane disease (NHMD) and its effect on respiratory function. Methods 96 children with NHMD were randomly divided into group A (n = 48) and group A (n = 48) treated with n SIMV plus PS. Group B was treated with nasal continuous positive airway pressure ventilation (n CPAP) and PS. The changes of static pulmonary compliance (Cstat), inspiratory peak flow (Insp flow), respiratory time constant and blood gas index, such as static pulmonary compliance (Cstat), inspiratory peak flow (Insp flow), blood gas index (p HPA CO 2Pa O 2 O 2 O 2) were compared between the two groups before treatment. The dosage of PS and ventilator time were recorded. The probability of intubation and the occurrence of complications. Results compared with those before treatment, On the 3rd day after treatment, the levels of CO _ 2 in Cstat Insp FlowPa O _ 2O _ 2 increased and Paco _ 2 decreased (P 0.05), and the level of CO _ 2 in group A was higher than that in group B (P 0.05). The total effective rate of upper intubation in group A was 93.755.The total effective rate of group A was 93.757.17, respectively, and that of group A was lower than that of group B (P 0.05), and that of group A was lower than that of group B (P 0.05), and that of group A was lower than that of group B (P 0.05). The probability of complications was 14.58 and 35.42, and the incidence of complications was 33.333.72.92 and there was significant difference between the two groups (P 0.05). Conclusion n SIMV combined with PS can significantly improve respiratory mechanics and blood gas index in children with NHMD.
【作者单位】：海南医学院第一附属医院;
【分类号】：R722.1

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