“滴定调节”早产儿吸入氧浓度方法的临床研究

The clinical research of "titration regulation" of fraction of inspired oxygen for premature infant oxygen therapy

目的探讨"滴定调节"早产儿吸入氧浓度方法的临床意义。方法随机选择需要吸氧的早产儿120例,分为观察组(60例)和对照组(60例),两组均用脉搏血氧仪监测,采用"30-60-90"规则按照目标脉搏血氧饱和度(SpO2)调节吸入氧浓度(FiO2),稳定半小时后进行血气分析。观察组采用"滴定调节"方法调节FiO2,每次FiO2变化为0.01;对照组采用常规方法调节FiO2,每次FiO2变化为0.05。测定动脉血氧分压(PaO2),计算两组早产儿PaO2达到正常范围的氧疗调节成功率。结果观察组氧疗调节成功率(82.1%)显著高于对照组(63.3%),差异有统计学意义(χ2=17.788,P<0.05);观察组PaO2大于90mmHg的发生率(9.2%)显著低于对照组(25.5%),差异有统计学意义(χ2=18.706,P<0.05);观察组PaO2小于50mmHg的发生率与对照组比较,差异无统计学意义(χ2=0.678,P>0.05)。结论 "滴定调节"新生儿吸入氧浓度方法能减少引起氧损伤或中毒的发生。

Objective To investigate the clinical significance of ＂titration regulation＂ in premature infant oxygen ther- apy. Methods One hundred and twenty cases of premature infants who needs oxygen therapy were divided into obser- vation group （60 cases） and control group （60 cases） randomly. The SpO2 （pulse oximetry saturation） of two groups were both monitored by pulse oximeter. The FiO2 （fraction of inspired oxygen）of premature for the target SpO2 with the ＂30- 60-90＂ regulation adjusted. The blood gas analysis were done 30 minutes after SpO2 stable. The FiO2 of observation group were altered by adjustment of 0.01 each time with the ＂titration regulation＂, and the FiO2 of control group were altered 0.05 each time as usual. The PaO2 of two groups were analyzed. Results The achievement ratio of the PaO2 meet the target of observation group （82.1%） was significantly higher than the ratio of control group （63.3%） （X^2= 17.788, P 〈 0.05）. The incidence rate of PaO2 higher than 90 mm Hg of observation group （9.2%） was significantly lower than the rate of control group （25.5%） （X^2=18.706, P 〈 0.05）. The difference of the incidence rate of PaO2 lower than 50 mm Hg between two groups was not significantly （X^2=0.678, P 〉 0.05）. Conclusion The adjustment of FiO2 with the ＂titration regulation＂ in premature infant oxygen therapy can alleviate the hyperoxic lung injury and oxygen toxicity.