呼吸窘迫综合征%呼吸力学%呼吸指数%氧合指数%婴儿,新生
呼吸窘迫綜閤徵%呼吸力學%呼吸指數%氧閤指數%嬰兒,新生
호흡군박종합정%호흡역학%호흡지수%양합지수%영인,신생
Respiratory distress syndrome%Respiratory mechanics%Respiratory index%Oxygenation index%Infant,newborn
目的 探讨呼吸力学指标在新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)中的应用价值.方法 选取2006年1月至2008年12月在本院新生儿重症监护室因NRDS需机械通气的患儿55例(均使用过肺表面活性物质治疗),根据其预后分为存活组(44例)和死亡组(11例),动态监测两组患儿机械通气过程中肺动态顺应性(compliance of the respiratory system,Crs)、呼吸指数(respiratory index,RI)、肺泡-动脉氧分压差PA-aO2及氧合指数(oxygenation index,OI)值的变化,并进行比较.结果 机械通气后6h,存活组和死亡组Crs、PA-aO2、OI及RI值比较,差异均有统计学意义(t值分别=6.871,-6.450,-10.316,-8.815,P均＜0.05).在机械通气过程中,存活组RI、PA-aO2和OI值随通气时间延长而逐渐降低,不同时间点RI、PA-aO2和OI值比较,差异均有统计学意义(F值分别=215.56,147.85,384.64,＜0.05).存活组Crs值随通气时间延长而逐渐升高,不同时间点Crs值比较,差异均有统计学意义(F=292,P＜0.05).死亡组患儿死亡前融、PA-aO2和OI值明显增高,与上机后6h比较,差异有统计学意义(r值分别=-5.699,-5.578,-6.924,p均＜0.05).死亡组患儿死亡前Crs值明显降低,与上机后6h比较,差异有统计学意义(t=11.767,P＜0.05).Crs和OI、RI、PA-aO2值间均呈负相关(r=-0.813,-0.800,-0.859,P＜0.05).结论 动态监测NRDS患儿机械通气时Crs、RI、OI、PA-aO2可以判断NRDS患儿治疗效果,指导呼吸机的合理应用,掌握脱机时机及评估预后.
目的 探討呼吸力學指標在新生兒呼吸窘迫綜閤徵(neonatal respiratory distress syndrome,NRDS)中的應用價值.方法 選取2006年1月至2008年12月在本院新生兒重癥鑑護室因NRDS需機械通氣的患兒55例(均使用過肺錶麵活性物質治療),根據其預後分為存活組(44例)和死亡組(11例),動態鑑測兩組患兒機械通氣過程中肺動態順應性(compliance of the respiratory system,Crs)、呼吸指數(respiratory index,RI)、肺泡-動脈氧分壓差PA-aO2及氧閤指數(oxygenation index,OI)值的變化,併進行比較.結果 機械通氣後6h,存活組和死亡組Crs、PA-aO2、OI及RI值比較,差異均有統計學意義(t值分彆=6.871,-6.450,-10.316,-8.815,P均＜0.05).在機械通氣過程中,存活組RI、PA-aO2和OI值隨通氣時間延長而逐漸降低,不同時間點RI、PA-aO2和OI值比較,差異均有統計學意義(F值分彆=215.56,147.85,384.64,＜0.05).存活組Crs值隨通氣時間延長而逐漸升高,不同時間點Crs值比較,差異均有統計學意義(F=292,P＜0.05).死亡組患兒死亡前融、PA-aO2和OI值明顯增高,與上機後6h比較,差異有統計學意義(r值分彆=-5.699,-5.578,-6.924,p均＜0.05).死亡組患兒死亡前Crs值明顯降低,與上機後6h比較,差異有統計學意義(t=11.767,P＜0.05).Crs和OI、RI、PA-aO2值間均呈負相關(r=-0.813,-0.800,-0.859,P＜0.05).結論 動態鑑測NRDS患兒機械通氣時Crs、RI、OI、PA-aO2可以判斷NRDS患兒治療效果,指導呼吸機的閤理應用,掌握脫機時機及評估預後.
목적 탐토호흡역학지표재신생인호흡군박종합정(neonatal respiratory distress syndrome,NRDS)중적응용개치.방법 선취2006년1월지2008년12월재본원신생인중증감호실인NRDS수궤계통기적환인55례(균사용과폐표면활성물질치료),근거기예후분위존활조(44례)화사망조(11례),동태감측량조환인궤계통기과정중폐동태순응성(compliance of the respiratory system,Crs)、호흡지수(respiratory index,RI)、폐포-동맥양분압차PA-aO2급양합지수(oxygenation index,OI)치적변화,병진행비교.결과 궤계통기후6h,존활조화사망조Crs、PA-aO2、OI급RI치비교,차이균유통계학의의(t치분별=6.871,-6.450,-10.316,-8.815,P균＜0.05).재궤계통기과정중,존활조RI、PA-aO2화OI치수통기시간연장이축점강저,불동시간점RI、PA-aO2화OI치비교,차이균유통계학의의(F치분별=215.56,147.85,384.64,＜0.05).존활조Crs치수통기시간연장이축점승고,불동시간점Crs치비교,차이균유통계학의의(F=292,P＜0.05).사망조환인사망전융、PA-aO2화OI치명현증고,여상궤후6h비교,차이유통계학의의(r치분별=-5.699,-5.578,-6.924,p균＜0.05).사망조환인사망전Crs치명현강저,여상궤후6h비교,차이유통계학의의(t=11.767,P＜0.05).Crs화OI、RI、PA-aO2치간균정부상관(r=-0.813,-0.800,-0.859,P＜0.05).결론 동태감측NRDS환인궤계통기시Crs、RI、OI、PA-aO2가이판단NRDS환인치료효과,지도호흡궤적합리응용,장악탈궤시궤급평고예후.
Objective To explore the clinical value of respiratory mechanics in neonates with neonatal respiratory distress syndrome (NRDS).Methods According to prognosis,55 newborns with NRDS who had been treated with pulmonary surfactant in our hospital from Jan 2006 to Dec 2008 were divided into 2 groups:44 newborns in survival group and 11 newborns in death group.The dynamical changes of compliance of the respiratory system (Crs),respiratory index (RI) and PA-a O2 were measured during mechanical ventilation.Results At 6 h after mechanic ventilation,there were significant differences in Crs,PA-a O2,OI and RI between the survival group and the death group (t=6.871,-6.450,-10.316,-8.815,P＜0.05 ).In the survival group,RI,PA-aO2 and OI decreased with the time of ventilation,and there were significant differences among the different time point ( F=215.56,147.85,384.64,P＜0.05).In the survival group,Crs increased with the time of ventilation,and there were significant differences among the different time point ( F=292,P＜0.05).In the death group,RI,PA-aO2 and OI increased respectively just before dying than at 6 h after mechanic ventilation (t=-5.699,-5.578,-6.924,P＜0.05 ).In the death group,Crs decreased respectively just before dying than at 6 h after mechanic ventilation (t=11.767,P＜0.05 ).Crs was negative correlated with OI,RI and PA-aO2 (r=-0.813,-0.800,-0.859,P＜0.05 ).Conclusion Monitoring in NRDS children's dynamic changes of Crs,RI,OI,PA-a O2 can help observing effect of treatment,guiding ventilator treatment,grasping the opportunity and assessing the prognosis offline in NRDS.
