呼吸窘迫综合征呼吸机相关性肺损伤应用肺保护性通气策略的疗效分析

Analysis of the efficacy of lung protective mechanical ventilation in neonatal respiratory distress syndrome patients with ventilator-induced lung injury

目的探讨新生儿呼吸窘迫综合征(NRDS)呼吸机相关性肺损伤应用肺保护性通气策略的疗效。方法选取右江民族医学院附属医院2010年6月-2012年6月收治的58例呼吸机相关性肺损伤(VILI)患儿,按照呼吸支持治疗方式分为观察组与对照组,每组各29例。观察组给予肺保护性通气策略支持治疗,对照组患儿采取传统机械通气策略进行治疗。对两组患儿观察指标进行比较分析。结果观察组治疗总有效率为96.55%(28/29),对照组为75.86%(22/29),两组比较差异有统计学意义(P<0.05);在治疗7 d后,观察组氧合指数、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)以及肿瘤坏死因子-α(TNF-α)水平分别是(264±25)mm Hg(1 mm Hg=0.133 kPa)、(74.3±40.6)、(142.2±14.9)、(170.4±98.8)pg/mL,均优于对照组(P<0.05);治疗前后两组患儿pH、静脉血氧分压均无差异(P>0.05)。结论对NRDS呼吸机相关性肺损伤应用肺保护性通气策略疗效显著,值得临床推广应用。

Objective To explore the efficacy of lung protective mechanical ventilation in neonatal respiratory distress syndrome patients with ventilator-induced lung injury.Methods In accordance with the treatment of respiratory support,58 patients of Affiliated Hospital of Youjiang Medical College For Nationalities from June 2010 to June 2012 were divided into the observation group and the control group,each group had 29 patients.The observation group were given lung protective mechanical ventilation to support treatment and control group children to take conventional me chanical ventilation strategy for treatment.Analysis of the two groups of patients observed indicators.Results The observation group total effective was 96.55%（28/29）,the control group was 75.86%（22/29）,there difference of total ef fective was significant（P 0.05）;the observation group after treatment 7 d oxygenation index,interleukin-8（IL-8）,interleukin-10（IL-10） and tumor necrosis factor-α（TNF-α） levels（264 ±25） mm Hg,（74.3 ±40.6）,（142.2 ±14.9）,（170.4±98.8） pg/mL,were better than the control group（P 0.05）;before and after treatment,difference of pH and blood oxygen partial pressure was not significant（P 0.05）.Conclusion Lung protective ventilation strategy can significantly improve the therapeutic effect of ventilator-induced lung injury.