[1]昌玲,王香春.两种机械通气方式联合肺表面活性物质治疗新生儿ALI/ARDS效果比较[J].青岛大学学报(医学版),2018,54(04):435-438,442.[doi:10.11712/jms201804014]
 CHANG Ling,WANG Xiangchun.CLINICAL EFFECTS OF TWO DIFFERENT WAYS OF MECHANICAL VENTILATION COMBINED WITH PULMONARY SURFACTANT IN TREATMENT OF ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME IN NEONATES: A COMPARATIVE ANALYSIS[J].JOURNAL OF QINGDAO UNIVERSITY (MEDICAL SCIENCES),2018,54(04):435-438,442.[doi:10.11712/jms201804014]
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两种机械通气方式联合肺表面活性物质治疗新生儿ALI/ARDS效果比较()
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《青岛大学学报(医学版)》[ISSN:2096-5532/CN:37-1217/R]

卷:
第54卷
期数:
2018年04期
页码:
435-438,442
栏目:
出版日期:
2018-07-05

文章信息/Info

Title:
CLINICAL EFFECTS OF TWO DIFFERENT WAYS OF MECHANICAL VENTILATION COMBINED WITH PULMONARY SURFACTANT IN TREATMENT OF ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME IN NEONATES: A COMPARATIVE ANALYSIS
文章编号:
2096-5532(2018)04-0435-05
作者:
昌玲1王香春2
(鄂东医疗集团黄石市中心医院(湖北理工学院附属医院),湖北 黄石 435000 1 儿科; 2 皮肤科)
Author(s):
CHANG Ling WANG Xiangchun
(Department of Paediatrics, Huangshi Central Hospital (Affiliated Hospital Of Hubei Polytechnic University), Huangshi 435000, China)
关键词:
急性肺损伤呼吸窘迫综合征新生儿高频通气肺表面活性剂治疗结果
Keywords:
acute lung injury respiratory distress syndromenewborn high-frequency ventilation pulmonary surfactants treatment outcome
分类号:
R722.12;R605.973
DOI:
10.11712/jms201804014
文献标志码:
A
摘要:
目的 对比两种不同的通气方式常频机械通气(CMV)和高频振荡通气(HFOV)分别联合肺表面活性物质(PS)对于新生儿急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)的治疗效果,为临床治疗提供依据。
方法 选取2013年6月—2016年6月在本院NICU住院且机械通气时间超过72 h的127例新生儿,根据不同治疗方式分为2组,CMV+PS组65例,HFOV+PS组62例。比较两组病儿的呼吸力学指标、机械通气时间、用氧时间、并发症发生率及预后。
结果 治疗12、24、48 h时,HFOV+PS组病儿血氧分压(PaO2)、PaO2/吸入氧浓度(FiO2)显著高于CMV+PS组(t=3.219~5.571,P<0.05),而动脉血二氧化碳分压(PaCO2)、氧合指数(OI)、呼吸指数(RI)显著低于CMV+PS组(t=2.787~5.001,P<0.05)。HFOV+PS组病儿的机械通气时间、用氧时间均显著短于CMV+PS组(t=2.298~4.036,P<0.05);两组病儿颅内出血及气漏发生率、治愈率比较,差异无统计学意义(P>0.05)。
结论 HFOV联合PS治疗能够有效改善ALI/ARDS新生儿的肺顺应性和氧合功能,并能显著缩短机械通气时间和用氧时间,有利于改善病儿预后,值得进一步推广。
Abstract:
Objective To compare the clinical effects of conventional mechanical ventilation (CMV) combined with pulmonary surfactant (PS) and high-frequency oscillatory ventilation (HFOV) combined with PS in the treatment of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) in neonates, and to provide evidence for clinical treatment of ALI/ARDS.
Methods A total of 127 newborns, who were hospitalized in the neonatal intensive care unit of our hospital from June 2013 to June 2016 and underwent mechanical ventilation for more than 72 h, were enrolled and divided into CMV+PS group (n=65) and HFOV+PS group (n=62) according to the treatment modality. The two groups were compared in terms of respiratory mechanical parameters, mechanical ventilation time, oxygen supply time, the incidence of complications, and prognosis.
Results At 12, 24, and 48 h of treatment, compared with the CMV+PS group, the HFOV+PS group had significantly higher arterial partial pressure of oxygen (PaO2) and PaO2/fraction of inspired oxygen (t=3.219-5.571, P<0.05) and significantly lower arterial partial pressure of carbon dioxide, oxygenation index, and respiratory index (t=2.787-5.001, P<0.05). Moreover, the mechanical ventilation time and the oxygen supply time were significantly shorter in the HFOV+PS group than in the CMV+PS group (t=2.298-4.036, P<0.05). However, there were no significant differences in the incidence of intracranial hemorrhage and gas leakage and the cure rate between the two groups (P>0.05).
Conclusion HFOV combined with PS can effectively improve the lung compliance and oxygenation function of neonates with ALI/ARDS and significantly reduce their time of mechanical ventilation and oxygen supply time, which is helpful to improve the prognosis. Therefore, this treatment modality holds promise for clinical application.
更新日期/Last Update: 2018-07-08