摘要
目的观察肺保护性通气策略对小儿急性呼吸窘迫综合征治疗的影响。方法 2014年1月至2016年1月湖南省儿童医院急救中心收治急性呼吸窘迫综合征患儿80例为研究对象,随机分为对照组和观察组各40例。对照组患儿采用传统机械通气策略,观察组采用肺保护性通气策略,其他治疗相同。观察治疗后的呼吸机参数主要包含吸气峰压、呼吸末正压、平均气道压、吸入氧浓度、呼吸频率;动脉血气分析;并发症情况。结果观察组患儿的吸气峰压、平均气道压、吸入氧浓度的参数值显著低于对照组,呼吸末正压、呼吸频率参数值显著高于对照组,差异有统计学意义(P<0.05)。观察组患儿pH、PaO_2显著低于对照组,PCO_2显著高于对照组,差异有统计学意义(P<0.05)。观察组患儿经过治疗后呼吸机肺损伤、脑室内出血、动脉导管开放发生率比较差异无统计学意义(P>0.05);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论小儿急性呼吸窘迫综合征治疗中应用肺保护性通气策略能够优化呼吸机参数,改善患儿动脉血气值,降低不良反应发生率,具有重要的临床价值和应用意义。
Objective To observe the effect of lung protective ventilation strategy on the treatment for children with acute respiratory distress syndrome.Methods From January2014to January2016,80cases of acute respiratory distress syndrome in Hunan Children's Hospital were randomly divided into the control group and the observation group,40cases in each group.The control group received traditional mechanical ventilation strategy,and the observation group adopted the lung protective ventilation strategy,the other treatments being the same.The indicators were observed after treatment,including inspiratory peak pressure,positive end expiratory pressure,mean airway pressure,inhaled oxygen concentration,respiratory rate,arterial blood gas analysis,and complications.Results The peak inspiratory pressure,mean airway pressure and suction parameters of oxygen concentration in observation group were significantly lower than those in control group,while positive end expiratory pressure and frequency of respiration parameters were significantly higher,the difference being statistically significant(P<0.05).The pH and PaO2of the observation group were significantly lower than those of the control group,and the PCO2was significantly higher than that of the control group,the difference being statistically significant(P<0.05).The incidence rate of ventilator induced lung injury,intraventricular hemorrhage and patent ductus arteriosus had no statistical difference after treatment in observation group(P>005),while the incidence rate of adverse reactions was lower than that of control group,the difference being statistically significant(P<0.05).Conclusion In the treatment of children with acute respiratory distress syndrome,the lung protective ventilation strategy can optimize the ventilator parameters,improve the arterial blood gas value of children,and reduce the incidence of adverse reactions,which has important clinical value and application significance.
作者
臧平
罗兰
ZANG Ping;LUO Lan(Hunan Children's Hospital,Changsha 410007,China)
出处
《中国中西医结合儿科学》
2017年第6期489-491,共3页
Chinese Pediatrics of Integrated Traditional and Western Medicine
关键词
急性呼吸窘迫综合征
肺保护性通气策略
机械通气
儿童
Acute respiratory distress syndrome
Lung protective ventilation strategy
Mechanical ventilation
Children
