摘要
目的探究容量目标通气(TTV)对于新生儿呼吸窘迫综合征(NRDS)临床疗效、动脉血气指标、血清Th1/Th2平衡的影响。方法随机选择2016年10月至2018年3月我院收治的NRDS患儿150例为研究对象,采用随机数表法将其分为TTV组、APV组及PCV组,各50例。TTV组采用SIMV+PSV+VCV通气模式,APV组采用SIMV+PRVC通气模式,PCV组采用SIMV+PSV通气模式。比较三组患儿的疗效、转归指标、治疗前、后动脉血气指标、血清Th1/Th2平衡变化情况。结果 TTV组、APV组的有创通气时间、住院时间、临床症状缓解时间均显著优于PCV组,差异具有统计学意义(P<0.05);TTV组住院时间长于APV组,临床症状缓解时间短于APV组(P<0.05);TTV组与APV有创通气时间、死亡率及并发症总发生率比较,差异无统计学意义(P>0.05)。治疗后48 h,TTV组患儿低碳酸血症发生率明显低于PCV组,差异具有统计学意义(P<0.05);与APV组比较,差异无统计学意义(P>0.05)。治疗后,三组患儿血清IFN-γ/IL-4均降低,且TTV组、APV组显著低于PCV组,TTV组低于APV组,差异具有统计学意义(P<0.05)。结论在NRDS患儿的临床治疗中,TTV可缩短有创通气时间及临床症状缓解时间改善患儿的动脉血气指标、促进血清Th1/Th2平衡,提高疗效。
Objective To investigate the influence targeted tidal volume ventilation （TTV） on the effect, arterial bloodgas indexes and balance of serum Th1/Th2 in children with neonatal respiratory distress syndrome （NRDS）. Methods Atotal of 150 children with NRDS admitted in our hospital from October 2016 to March 2018 were randomly selected anddivided into TTV group, APV group and PCV group by random number table method, with 50 cases in each group. TheTTV group was treated with SIMV＋PSV＋VCV ventilation mode, the APV group was treated with SIMV＋PRVC ventilationmode, the PCV group was treated with SIMV＋PSV ventilation mode. The efficacy and outcome indexes, arterial blood gasindexes and balance of serum Th1/Th2 of the three groups before and after treatment were compared. Results The invasiveventilation time, hospitalization time and clinical symptom relief time of TTV group and APV group were significantlybetter than those of the PCV group, the differences were statistically significant （P〈0.05）. The hospitalization time of TTVgroup was longer than that of the APV group, the clinical symptom relief time of TTV group was shorter than that of theAPV group（P〈0.05）. There were no significant differences in invasive ventilation time, mortality rates and total incidencesof complications between the TTV group and the APV group （P〉0.05）. At 48 hours after treatment, the incidence ofhypocapnia in the TTV group was significantly lower than that in the PCV group（P〈0.05）, while compared with that of theAPV group, the difference was not statistically significant （P〉0.05）. After treatment, the serum IFN-γ/IL-4 of the three groups decreased, and that in the TTV group and the APV group were significantly lower than the PCV group, and that inthe TTV group was lower than the APV group （P〈0.05）. Conclusion In the clinical treatment of children with NRDS, TTVcan shorten the time of invasive ventilation and clinical symptom relief time improve the arterial blood gas indexes, promotethe balance of serum Th1/Th2, and improve the curative effect.
作者
辛颖军
赵海侠
宫瑞君
XIN Ying-jun;ZHAO Hai-xia;GONG Rui-jun(Zhouzhi County People＇s Hospital,Xi＇an 710400;Baoji Maternal and Child Health Care Hospital,Baoji 721000;Xi＇an Jiren Hospital,Xi＇an 710300,China)
出处
《临床医学研究与实践》
2018年第34期92-94,共3页
Clinical Research and Practice
