中外健康文摘
中外健康文摘
중외건강문적
WORLD HEALTH DIGEST
2012年
33期
95-96
,共2页
王洲洪(通讯作者)%段玉会%李格花%林广
王洲洪(通訊作者)%段玉會%李格花%林廣
왕주홍(통신작자)%단옥회%리격화%림엄
鼻塞式%气管插管%同步间歇指令通气%新生儿肺透明膜病
鼻塞式%氣管插管%同步間歇指令通氣%新生兒肺透明膜病
비새식%기관삽관%동보간헐지령통기%신생인폐투명막병
nasal tracheal%intubation%synchronized intermittentmandatory ventilation%hyalinemembranedisease
目的比较鼻塞式同步间歇指令通气(nSIMV)与气管插管后同步间歇指令通气(SIMV)在新生儿肺透明膜病辅助呼吸治疗中临床疗效。方法对需机械通气辅助呼吸92例新生儿肺透明膜病(Ⅰ~Ⅲ期)患儿分组,46例进行nSIMV治疗,46例予气管插管后SIMV治疗。监测肺动脉血流速度、心输出量、心率、血压、血气分析,记录两组FiO2、PaO2、PaCO2及氧合指数(OI)的变化,比较两组48小时后细菌培养阳性率、抗菌素使用时间、喂养不耐受、镇静剂使用时间、住院时间、住院费用。结果两组治疗6h、24h、48h、72h后患儿的肺动脉血流速度、心输出量、PaO2、OI、PaO2/FiO2与治疗前比较,差异均有统计学意义；而两组各对应时间点比较,两组间差异无统计学意义；nSIMV组治疗各治疗时间点的FiO2、PaCO2、心率、血压与SIMV组相比,差异均无统计学意义。两组48小时后细菌培养阳性率、抗菌素使用时间、喂养不耐受、镇静剂使用时间、住院时间、住院费用比较,差异有统计学意义。结论 nSIMV技术简单易掌握,对Ⅰ~Ⅲ期HMD治疗安全有效,并发症少,临床值得推广。
目的比較鼻塞式同步間歇指令通氣(nSIMV)與氣管插管後同步間歇指令通氣(SIMV)在新生兒肺透明膜病輔助呼吸治療中臨床療效。方法對需機械通氣輔助呼吸92例新生兒肺透明膜病(Ⅰ~Ⅲ期)患兒分組,46例進行nSIMV治療,46例予氣管插管後SIMV治療。鑑測肺動脈血流速度、心輸齣量、心率、血壓、血氣分析,記錄兩組FiO2、PaO2、PaCO2及氧閤指數(OI)的變化,比較兩組48小時後細菌培養暘性率、抗菌素使用時間、餵養不耐受、鎮靜劑使用時間、住院時間、住院費用。結果兩組治療6h、24h、48h、72h後患兒的肺動脈血流速度、心輸齣量、PaO2、OI、PaO2/FiO2與治療前比較,差異均有統計學意義；而兩組各對應時間點比較,兩組間差異無統計學意義；nSIMV組治療各治療時間點的FiO2、PaCO2、心率、血壓與SIMV組相比,差異均無統計學意義。兩組48小時後細菌培養暘性率、抗菌素使用時間、餵養不耐受、鎮靜劑使用時間、住院時間、住院費用比較,差異有統計學意義。結論 nSIMV技術簡單易掌握,對Ⅰ~Ⅲ期HMD治療安全有效,併髮癥少,臨床值得推廣。
목적비교비새식동보간헐지령통기(nSIMV)여기관삽관후동보간헐지령통기(SIMV)재신생인폐투명막병보조호흡치료중림상료효。방법대수궤계통기보조호흡92례신생인폐투명막병(Ⅰ~Ⅲ기)환인분조,46례진행nSIMV치료,46례여기관삽관후SIMV치료。감측폐동맥혈류속도、심수출량、심솔、혈압、혈기분석,기록량조FiO2、PaO2、PaCO2급양합지수(OI)적변화,비교량조48소시후세균배양양성솔、항균소사용시간、위양불내수、진정제사용시간、주원시간、주원비용。결과량조치료6h、24h、48h、72h후환인적폐동맥혈류속도、심수출량、PaO2、OI、PaO2/FiO2여치료전비교,차이균유통계학의의；이량조각대응시간점비교,량조간차이무통계학의의；nSIMV조치료각치료시간점적FiO2、PaCO2、심솔、혈압여SIMV조상비,차이균무통계학의의。량조48소시후세균배양양성솔、항균소사용시간、위양불내수、진정제사용시간、주원시간、주원비용비교,차이유통계학의의。결론 nSIMV기술간단역장악,대Ⅰ~Ⅲ기HMD치료안전유효,병발증소,림상치득추엄。
Objective To evaluate the efficacy of nasal synchronized intermittentmandatory ventilation and synchronized intermittentmandatory ventilation after tracheal intubation in the treatment of assisted respiration ofhyalinemembranedisease. Methodsdivide 92 infants withhyalinemembranedisease which needmechanical ventilation intogroups,46 infants to nSIMV treatment,46 infants to tracheal intubation SIMV treatment.Monitoring the average blood speed of lung arteries, cardiac output,theheart rate, blood pressure, Bloodgas analysis.Record twogroups change of PaO2 FiO2, PaCO2 and oxygenation index (OI).Compare two sets of the germiculture positive rate after 48hours , AntibioticUsed time, feeding intolerance,sedativeUsed time, the length of stay, charge of be inhospital.Results Twogroups of treatment for 6h,24h,48h ,72h and the pulmonary artery blood flow velocity, cardiac output, PaO2, OI, PaO2/ FiO2 Compared with before treatment,thedifferencehave statistical significance.And the twogroups each corresponding time point comparison, thedifferencehave no statistical significance.Compare two sets of the germiculture positive rate after 48hours , AntibioticUsed time, feeding intolerance,sedativeUsed time, the length of stay, charge of be inhospital,thedifferencehave statistical significance.Conclusion The technology of nSIMV is easy tomaster, which tohMD(Ⅰ~Ⅲperiod) of treatment is safe and effective, less complications.Be worth expanding in clinical.
