肺保护性通气在早产儿重症呼吸窘迫综合征中的应用效果研究

Application of protective pulmonary ventilation on severe respiratory distress syndrome in premature infants of lung protective ventilation in premature infants with severe respiratory distress syndrome

目的研究并探讨肺保护性通气在早产儿重症呼吸窘迫综合征中的应用效果。方法入组对象选择2015年3月~2017年10月期间我院收治的92例重症呼吸窘迫综合征早产儿,按照计算机随机数字表法,随机将这92例早产儿分为两组,各46例,观察组采取肺保护性通气策略,而对照组未采取肺保护性通气策略,比较组间血气分析指标、呼吸机参数、机械通气时间、住院时间、呼吸机相关性肺炎发生率。结果两组PaO_2、PaCO_2、pH值比较均无统计学意义(P> 0.05),但观察组的吸气峰压、平均呼吸道压均低于对照组(P <0.05),其呼气末正压高于对照组(P <0.05)。观察组的机械通气时间、住院时间均短于对照组(P <0.05),其呼吸机相关性肺炎发生率显著低于对照组(P <0.05)。结论在重症呼吸窘迫综合征早产儿的机械通气治疗期间,对患儿实施肺保护性通气策略,安全有效。

Objective To study and explore the effect of protective pulmonary ventilation on severe respiratory distress syndrome in premature infants. Methods A total of 92 preterm infants with severe respiratory distress syndrome admitted to our hospital from March 2015 to October 2017 were selected and randomly divided into two groups according to the computer random number grouping method, 46 cases in each group. The patients in the observation group received protective pulmonary ventilation strategy, while the control group did not take protective pulmonary ventilation strategy. Blood gas analysis indexes, respirator parameters, mechanical ventilation time, hospitalization time and the incidence of ventilator-associated pneumonia were compared between the two groups. Results There was no significant difference in PaO2, PaCO2 and pH between the two groups（P 〉 0.05）, but in the observation group, the peak inspiratory pressure and mean airway pressure were lower than those in the control group（P 〈 0.05）. Positive end expiratory pressure was higher than the control group（P 〈 0.05）. The duration of mechanical ventilation and hospital stay in observation group were shorter than those in control group（P 〈 0.05）, and the incidence of ventilator-associated pneumonia was significantly lower in the observation group than in the control group（P 〈 0.05）. Conclusion During the period of mechanical ventilation in premature infants with severe respiratory distress syndrome, it is safe and effective to carry out protective pulmonary ventilation in children.