压力调节容量控制通气模式治疗新生儿呼吸窘迫综合征的临床观察

Clinical observation on the pressure regulated volume control ventilation in the treatment of neonatal respiratory distress syndrome

目的观察压力调节容量控制通气(PRVC)治疗新生儿呼吸窘迫综合征(NRDS)的临床效果。方法对15例新生儿呼吸窘迫综合征患儿采用PRVC模式进行机械通气治疗,通气过程中,采用肺保护性策略。观察呼吸、心率、动脉血气(PaO2)、氧合指数(OI)等变化。结果 15例患儿均痊愈出院,其中1例转为高频通气后治愈。平均通气时间为(6.60±5.73)d,平均吸氧时间为(10.93±8.46)d,平均住院时间为(19.73±14.63)d。机械通气后,患儿呼吸频率明显减慢(P<0.05),渐接近正常或者正常;患儿各个时间点pH值、PaCO2值和PaO2值均在正常范围内,各时间点比较,差异无统计学意义(P>0.05);患儿OI均随着通气时间延长而逐步减小,差异有统计学意义(P<0.05)。结论 PRVC通气模式治疗NRDS时,可减少肺气压伤的发生,是一种肺保护性通气模式。

Objective To observe the effect of the pressure regulated volume control （PRVC） ventilation in treating neonatal respiratory distress syndrome （NRDS）. Methods 15 cases of NRDS who required mechanical ventilation were treated by PRVC model. In the process of the ventilation, lung protective strategies were applied.The respiratory rate, heart rate and arterial blood gas （PaO2）, oxygen index （OI） was observed. Results The 15 cases of patients all have been cured, among them 1 case was cured finally after high frequency ventilation （HFV）. The mean duration of mechanical ventilation was （6.60±5.73） days; the average time for oxygen was （10.93±8.46） days; the average hospitalization time was （19.73±14.63） days. On the PRVC ventilation, respiratory frequency were significantly slower （P〈0.05）. The pH, PaCO2 and PaO2 were in the normal range at all time points; they gradually closed to normal or arrived at normal. There were no statistically significant differences at all time points （P〉0.05）. OI decreased gradually as time passed and there were statistically significant differences at each time point（P〈0.05）. Conclusion PRVC ventilation re- duced the incidence of pulmonary barotraumas in the treatment of NRDS. So it is a lung protective ventilation mode.