辅助/控制通气治疗新生儿急性肺损伤的探讨

Use of Assist-Control Ventilation in the Treatment of Neonatal Acute Lung Injury

目的探讨辅助/控制通气(ACV)较传统通气治疗新生儿急性肺损伤的优越性及其临床应用价值。方法62例因急性肺损伤需用机械通气治疗的新生儿,32例用辅助控制通气;30例用间歇正压通气(IPPV)。将两组患儿的呼吸机参数氧浓度(FiO2)、吸气峰压(PIP)和肺氧合功能指标在0、2、6、12、24 h进行组内比较,并比较两组患儿平均上机时间以及并发症的多少。结果ACV组在上机后6 h FiO2、PIP有显著下降(P<0.05)。而IPPV组在上机12 h FiO2开始下降、上机24 h PIP才有显著下降(P<0.05)。上机2 h ACV组肺氧合功能指标较上机前明显改善,差异有统计学意义(P<0.05),而IPPV组在上机后6 h出现显著改变。ACV组平均上机时间明显缩短(P<0.05),机械通气并发症也较IPPV组明显减少(P<0.05)。结论需用机械通气的新生儿,ACV通气方式能更快地降低FiO2和PIP,改善通气和氧合,缩短上机时间,减少并发症的发生率。

Objective To review the experience of using assist-control ventilation （ACV） in the treatment of neonatal acute lung injury. Methods Sixty-two neonates suffering from acute lung injury and requiring mechanical ventilation were divided into two groups. One group of 32 was treated by ACV and the other group of 30 by intermittent positive pressure ventilation （IPPV）. FiO2, PIP, oxygenation index, average time of ventilation and complications were compared between the two groups. Results FiO2 and PIP dropped in 6 hours of ventilation in ACV group. Oxygenation index was obviously improved 2 hours after use of ACV and 6 hours after use of IPPV. Average time of ventilation was shorter in ACV group than in IPPV group. The rate of complications was less in ACV group than in IPPV group. Conclusion ACV is superior to IPPV in the treatment of neonatal acute lung injury.