摘要
目的探讨压力控制法肺复张联合容量导向机械通气治疗新生儿呼吸窘迫综合征(NRDS)的效果。方法选取2018年1月至2020年12月上饶市妇幼保健院收治的62例NRDS患儿作为研究对象,采用随机数字表法将其分为对照组与试验组,每组各31例。对照组患儿出生后6 h内予以肺表面活性物质联合容量导向机械通气治疗,试验组患儿在对照组的基础上加用压力控制法肺复张。比较两组患儿的呼吸参数指标[二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))、吸入氧浓度(FiO_(2))]、血流动力学指标[收缩压(SBP)、心率(HR)]和不良反应。结果治疗前,两组患儿的PaCO_(2)、PaO_(2)、FiO_(2)水平比较,差异无统计学意义(P>0.05);治疗1、6 h后,试验组患儿的PaCO_(2)、FiO_(2)水平低于对照组,PaO_(2)高于对照组,差异有统计学意义(P<0.05)。两组患儿治疗前、治疗后不同时点的SBP、HR比较,差异无统计学意义(P>0.05)。两组患儿的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在NRDS患儿中采用压力控制法肺复张联合容量导向机械通气的治疗效果较好,有利于改善呼吸参数指标,维持血流动力学稳定,且未发生明显不良反应,值得推广应用。
Objective To explore the effect of pressure controlled lung recruitment combined with volume guided mechanical ventilation in the treatment of neonatal respiratory distress syndrome(NRDS).Methods A total of 62 children with NRDS admitted to Shangrao maternal and child health hospital from January 2018 to December 2020 were selected as the research objects and divided into the control group and the experimental group by random number table methd,with 31 cases in each group.The control group was given pulmonary surfactant combined with volume guided mechanical ventilation within 6 hours after birth,and the experimental group was given pressure controlled lung recruitment on the basis of the control group.The respiratory parameters(partial pressure of carbon dioxide[PaCO_(2)],partial blood oxygen pressure[PaO_(2)],inhaled oxygen concentration[FiO_(2)]),hemodynamic indexes(systolic blood pressure[SBP],heart rate[HR])and adverse reactions were compared between the two groups.Results Before treatment,there were no statistically significant differences in PaCO_(2),PaO_(2) and FiO_(2) levels between the two groups(P>0.05).After 1 and 6 h of treatment,the PaCO_(2) and FiO_(2) levels in the experimental group were lower than those in the control group,while PaO_(2) levels were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in SBP and HR between the two groups at different time points before and after treatment(P>0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Pressure controlled lung recruitment combined with volume guided mechanical ventilation is effective in the treatment of NRDS children,which is conducive to improving respiratory parameters and maintaining hemodynamic stability without obvious adverse reactions,and is worthy of popularization and application.
作者
陈琦
CHEN Qi(Department of Neonatal,Shangrao Maternal and Child Health Hospital,Jiangxi Province,Shangrao 334000,China)
出处
《中国当代医药》
CAS
2021年第27期136-139,共4页
China Modern Medicine
基金
江西省卫生计生委科技计划项目(20194078)。
关键词
新生儿呼吸窘迫综合征
压力控制法
肺复张
容量导向机械通气
呼吸参数
血流动力学
Neonatal respiratory distress syndrome
Pressure control method
Lung recruitment
Mechanical ventilation for volume targets
Respiratory parameters
Hemodynamics
作者简介
陈琦(1980-),男,江西上饶人,副主任医师,研究方向:新生儿危重症救治。
