摘要
目的：观察用肺保护性通气策略和呼吸力学监护指导新生儿呼吸衰竭的机械通气，以降低呼吸机相关性肺损伤。方法：回顾性分析我院2008年2月-2010年12月收治入院的30例急性呼吸衰竭的早产儿，随机分为机械通气组（对照组）和保护性机械通气组（观察组），观察两组治疗前后潮气量（VT）、呼吸道峰压（PIP）、呼气末正压（PEEP）、呼吸频率（RR）及血气分析结果。结果：本研究中两组所有患儿均治愈，顺利撤机。两组患儿治疗后呼吸机参数比较。观察组VT（8．2±0．9）ml／kg、PIP（35．1±3．8）cmH20（1cmH20=0．098kPa），对照组VT（10．5±0．5）ml／kg、PIP（45．5±3．7）cmH2O，两组VT、PIP比较，差异有高度统计学意义（P〈0．01）；观察组采用允许性高碳酸血症，平均PaCO2值高于对照组，差异有高度统计学意义（P〈0．01）；对照组呼吸机相关性肺损伤（VILI）的发生率为33．33％（5／15），观察组VILI的发生率为13．33％（2／15），两组比较差异有统计学意义（P〈0．05）。结论：早产儿的保护性机械通气能够有效治愈患儿的呼吸衰竭，而且并发症相对较少。
Objective： To guide mechanical ventilation of neonatal respiratory failure with lung protective ventilation strategy and respiratory mechanics monitoring, and reduce ventilator-associated lung injury. Methods： 30 case of premature infant with acute respiratory failure in our hospital from February 2008 to December 2010 were randomly divided into mechanical ventilation group （control group） and the protection of the mechanical ventilation group （observation group）. The tidal vol- ume （VT）, peak airway pressure （PIP）, end-expiratory upright （PEEP）, respiratory rate （RR） and blood gas analysis results before and after treatment were observed. Results： All patients were cured in both groups and wean smooth, the differences of VT, PIP.after treatment in observation group [VT（8.2±0.9） ml/kg, PIP（35.1±3.8）cm H20] （1 cm H20=0.098 kPa）and control group [VT（10.5±0.5） ml/kg, PIP（45.5±3.7）cm H20] were compared, and there was a significant difference between them （P〈0.01）. Observation group were treated with permissive hypercapnia, the average PaCO2 was significantly higher than that of the control group （P〈0.01）; The incidence of VILI in control group was 33.33% （5/15）, and 13.33% （2/15） in observation group, the difference of two groups was statistically significant （P〈0.05）. Conclusion： The preterm infant＇s protective mechanical ventilation can effectively cure infant with respiratory failure and complications is relatively small.
出处
《中国医药导报》
CAS
2011年第31期72-73,80,共3页
China Medical Herald
关键词
早产儿
机械通气
保护性策略
Preterm children
Mechanical ventilation
Protective strategies
