双水平正压通气、持续气道正压通气在新生儿急性肺损伤治疗中的应用对比观察

发布时间：2019-05-22 20:51

【摘要】：目的比较双水平正压通气(Duo PAP)、持续气道正压通气(CPAP)在新生儿急性肺损伤(ALI)治疗中的应用效果。方法 70例ALI患儿分为Duo PAP组40例和CPAP组30例,比较两组治疗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),记录两组呼吸支持时间、用氧时间及再插管、气漏、颅内出血、治愈例数。结果组内不同时点PaO_2、PaCO_2、PaO_2/FiO_2、OI、RI两两比较,P均0.05;组间治疗24、48、72 h的PaO_2、PaCO_2、PaO_2/FiO_2、OI、RI比较,P均0.05;Duo PAP组呼吸支持时间(76±13)h、用氧时间(123±35)h、再插管5例(12.5%),CPAP组分别为(92±18)h、(155±42)h、9例(25.7%),两组比较,P均0.05;Duo PAP组气漏3例(7.5%)、颅内出血10例(25.0%)、治愈38例(95%),CPAP组分别为2例(6.7%)、8例(26.7%)、28例(93.3%),两组比较,P均0.05。结论 Duo PAP、CPAP用于新生儿ALI治疗中可迅速改善通气和氧合;Duo PAP在降低呼吸支持时间、氧暴露时间及减少再插管发生上面优于CPAP,且不增加并发症发生率,可作为治疗ALI的首选呼吸支持模式。
[Abstract]:Objective to compare the effect of double level positive pressure ventilation (Duo PAP),) continuous positive airway pressure ventilation (CPAP) in the treatment of neonatal acute lung injury (ALI). Methods 70 children with ALI were divided into Duo PAP group (n = 40) and CPAP group (n = 30). The respiratory support time of the two groups was recorded by PaO_2,PaCO_2,PaO_2/FiO_2, oxygenation index (OI), respiratory index (RI), at 72 h after treatment for 0, 12, 24, 48 and 72 hours. The number of cases cured with oxygen time and re-intubation, air leakage, intracranial hemorrhage. Results there was a pairwise comparison of PaO_2,PaCO_2,PaO_2/FiO_2,OI,RI at different time points in the group (P = 0.05), and there was a significant difference in PaO_2,PaCO_2,PaO_2/FiO_2,OI,RI between the two groups at 24 h, 48 h and 72 h (P < 0.05). In Duo PAP group, the respiratory support time was (76 卤13) h, the oxygen use time was (123 卤35) h, and the re-intubation time was (92 卤18) h, (155 卤42) h in 5 cases (12.5%), CPAP group), and 9 cases (25.7%) in), CPAP group. In Duo PAP group, air leakage occurred in 3 cases (7.5%), intracranial hemorrhage in 10 cases (25.0%), cured in 38 cases (6.7%), 8 cases (26.7%) and 28 cases (93.3%) in 95%), CPAP group. All P were 0.05. Conclusion Duo PAP,CPAP can rapidly improve ventilation and oxygenation in the treatment of neonatal ALI. Duo PAP is superior to CPAP, in reducing respiratory support time, oxygen exposure time and re-intubation, and does not increase the incidence of complications, which can be used as the preferred respiratory support mode for the treatment of ALI.
【作者单位】：江苏大学附属医院;
【基金】：江苏大学临床专项基金(JDLCZX014)
【分类号】：R722.1

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