不同通气模式在新生兔重症胎粪吸入综合征的应用比较

Comparison of different ventilation modes on newborn rabbits with severe meconium aspiration syndrome

目的观察A/C、CMV、SIMV模式在新生兔重症胎粪吸入综合征上具体的呼吸机参数变化。方法将18只新生兔按照不同通气模式随机分为3组:SIMV组、A/C组、CMV组。每组通气30 min后记录相关参数。以维持潮气量正常范围(4～10ml/kg)及正常血氧饱和度(85%以上)为准。观察新生兔肺动态顺应性(Cydn)、平均气道压(MAP)、每分钟通气量(MV)、潮气量(VT)、呼吸频率(RR)、心率(HR)数值的变化。结果 3种模式间,HR数值和VT数值的比较,差异无统计学意义;3种模式间,RR数值、Cydn数值、MAP数值和MV数值的比较,差异有统计学意义。结论 3种通气模式的呼吸机参数变化均有一定的规律可循,从机械性肺损伤的角度来看,SIMV模式可作为治疗重症MAS的首选模式。

Objective To observe the changes of lung dynamic compliance（Cydn）,mean airway pressure（MAP）,minute ventilation（MV）,tidal volume（VT）,respiratory rate（RR） and heart rate（HR） in the newborn rabbits with severe meconium aspiration syndrome.Methods Eighteen newborn rabbits were divided randomly into 3 groups of Assistor Control Mandatory Ventilation（A/C）,Control Mandatory Ventilation（CMV） and Synchronized intermittent Mandatory Ventilation（SIMV）.Set the parameters in order to maintain normal tidal volume range（4～10 ml/kg） and normal oxygen saturation（85% or more）.The pulmonary dynamic compliance（Cydn）,mean airway pressure（MAP）,minute ventilation（MV）,tidal volume（VT）,respiratory rate（RR） and heart rate（HR） were observed.Results In the three modes,there were no statistically significant differences in HR（F=0.649,P=0.593） and VT（F=2.548,P=0.085）.But there were statistically significant differences in RR（F=240.057P=0.000）,Cydn（F=311.309P=0.000）,MAP（F=127.354P=0.000） and MV（F=25.136P=0.000）.Among them,the mean airway pressure of A/C group was the highest and the lung dynamic compliance of SIMV group was the highest.Conclusion The above ventilator parameters have certain regularity,which can be inferred that SIMV mode can be used as the preferred mode of treatment of severe MAS.