解放军医药杂志
解放軍醫藥雜誌
해방군의약잡지
MEDICAL&PHARMACEUTICAL JOURNAL OF CHINESE PEOPLE'S LIBERATION ARMY
2014年
11期
68-71
,共4页
呼吸窘迫综合征,新生儿%呼吸,人工%目标容量控制通气%疗效比较研究
呼吸窘迫綜閤徵,新生兒%呼吸,人工%目標容量控製通氣%療效比較研究
호흡군박종합정,신생인%호흡,인공%목표용량공제통기%료효비교연구
Respiratory distress syndrome,newborn%Respiration,artificial%Targeted tidal volume ventilation%Comparative effectiveness research
目的：观察同步间歇指令通气( SIMV)联合压力调节( PSV)加目标容量控制通气( TTV)治疗新生儿呼吸窘迫综合征( NRDS)的效果。方法将唐山市妇幼保健院2011年4月—2014年4月收治的53例NRDS患儿分为SIMV+PSV+TTV组( n=27例)和辅助/控制通气组( A/C组,n=26),记录两组治疗不同时间点的氧合状况、并发症发生及转归情况。结果 SIMV+PSV+TTV组在机械通气6 h时动脉血氧分压/吸入氧体积分数( P/F)和肺泡-动脉血氧分压比(a/APO2)即明显优于0 h(P<0．05),氧合改善较A/C组迅速,两组在治疗6 h后P/F和a/APO2均有显著改善趋势(P<0．05)；SIMV+PSV+TTV组P/F和a/APO2在治疗6、24、72 h时均优于A/C组(P<0．05)。 SIMV+PSV+TTV组气漏综合征和呼吸机相关性肺炎的发生率均低于A/C组( P<0．05)；两组病死率差异无统计学意义(P>0．05)。结论 SIMV+PSV+TTV模式比A/C模式能更迅速地改善NRDS患儿的氧合状况,减少氧暴露,降低高容量通气导致的并发症,是治疗NRDS的有效方法。
目的：觀察同步間歇指令通氣( SIMV)聯閤壓力調節( PSV)加目標容量控製通氣( TTV)治療新生兒呼吸窘迫綜閤徵( NRDS)的效果。方法將唐山市婦幼保健院2011年4月—2014年4月收治的53例NRDS患兒分為SIMV+PSV+TTV組( n=27例)和輔助/控製通氣組( A/C組,n=26),記錄兩組治療不同時間點的氧閤狀況、併髮癥髮生及轉歸情況。結果 SIMV+PSV+TTV組在機械通氣6 h時動脈血氧分壓/吸入氧體積分數( P/F)和肺泡-動脈血氧分壓比(a/APO2)即明顯優于0 h(P<0．05),氧閤改善較A/C組迅速,兩組在治療6 h後P/F和a/APO2均有顯著改善趨勢(P<0．05)；SIMV+PSV+TTV組P/F和a/APO2在治療6、24、72 h時均優于A/C組(P<0．05)。 SIMV+PSV+TTV組氣漏綜閤徵和呼吸機相關性肺炎的髮生率均低于A/C組( P<0．05)；兩組病死率差異無統計學意義(P>0．05)。結論 SIMV+PSV+TTV模式比A/C模式能更迅速地改善NRDS患兒的氧閤狀況,減少氧暴露,降低高容量通氣導緻的併髮癥,是治療NRDS的有效方法。
목적：관찰동보간헐지령통기( SIMV)연합압력조절( PSV)가목표용량공제통기( TTV)치료신생인호흡군박종합정( NRDS)적효과。방법장당산시부유보건원2011년4월—2014년4월수치적53례NRDS환인분위SIMV+PSV+TTV조( n=27례)화보조/공제통기조( A/C조,n=26),기록량조치료불동시간점적양합상황、병발증발생급전귀정황。결과 SIMV+PSV+TTV조재궤계통기6 h시동맥혈양분압/흡입양체적분수( P/F)화폐포-동맥혈양분압비(a/APO2)즉명현우우0 h(P<0．05),양합개선교A/C조신속,량조재치료6 h후P/F화a/APO2균유현저개선추세(P<0．05)；SIMV+PSV+TTV조P/F화a/APO2재치료6、24、72 h시균우우A/C조(P<0．05)。 SIMV+PSV+TTV조기루종합정화호흡궤상관성폐염적발생솔균저우A/C조( P<0．05)；량조병사솔차이무통계학의의(P>0．05)。결론 SIMV+PSV+TTV모식비A/C모식능경신속지개선NRDS환인적양합상황,감소양폭로,강저고용량통기도치적병발증,시치료NRDS적유효방법。
Objective To observe the effect of synchronized intermittent mandatory ventilation (SIMV) com-bined with pressure support ventilation ( PSV) and targeted tidal volume ( TTV) in treatment of neonatal respiratory dis-tress syndrome ( NRDS) . Methods Fifty-three NRDS neonates in Maternal and Child Health Hospital of Tangshan dur-ing April 2011 and April 2014 were randomly divided into SIMV+PSV+TTV group ( n=27 ) and assist/control group (A/C group, n=26), and the oxygenation status, complication incidence and turnover rates were recorded in the two groups at different time points. Results The score of arterial partial pressure of oxygen/inspired oxygen ( P/F) and alve-olar-arterial partial pressure of oxygen ( a/APO2 ) in the SIMV+PSV+TTV group on 6 h after ventilation were signifi-cantly improved, compared with those on 0 h (P<0. 05), and oxygenation improvement in the SIMV+PSV+TTV group was quicker, compared with that in A/C group, and the values of P/F and a/APO2 were significantly improved in the two groups on 6 h after ventilation (P<0. 05);compared with those in A/C group, the values of P/F and a/APO2 were sig-nificantly improved on 6 h, 24 h and 72 h after ventilation in the SIMV+PSV+TTV group (P<0. 05). The incidence rates of air leak syndromes and ventilator-associated pneumonia ( VAP) in the SIMV+PSV+TTV group were lower than those in the A/C group (P<0. 05). There was no significant difference in the fatality rates between the two groups (P>0. 05). Conclusion Compared with those by A/C mode, SIMV+PSV+TTV mode may improve the oxygenation status more quickly, decrease the incidence rates of air leak syndromes and VAP in NRDS neonates, and it is an effective meth-od in treatment of NRDS.
