不同机械通气方式对新生儿呼吸窘迫综合征并发症影响

Effect of Different Mechanical Ventilation Methods on Complications of Neonatal Respiratory Distress Syndrome

目的研究不同机械通气方式对新生儿呼吸窘迫综合征并发症的影响。方法根据入院先后顺序将方便选取该院接收的呼吸窘迫综合征新生儿74例分为对照组和观察组,每组37例,均接受基础治疗,再分别采取间歇指令通气法、高频振荡通气法。将两组的临床各项指标进行比对。结果观察组呼吸窘迫综合征新生儿治疗后的动脉血氧分压(71.23±6.15)mmHg及血氧饱和度(96.78±3.04)%均高于对照组,动脉二氧化碳分压(46.68±4.16)mmHg低于对照组,差异有统计学意义(t=5.444、4.236、5.512,P<0.05);观察组患儿的有创通气时间(74.50±30.22)h、无创通气时间(38.14±18.97)h、氧暴露时间(151.36±33.49)h均短于对照组,差异有统计学意义(t=3.221、3.625、5.276,P<0.05);观察组新生儿的心率(19.76±1.25)次/min低于对照组,Ti(0.91±0.08)s、呼吸时间(1.63±0.04)s短于对照组,潮气量(9.93±1.28)mL/kg高于对照组,差异有统计学意义(t=9.779、9.808、17.682、4.703,P<0.05);观察组患儿并发症发生率[肺气漏(2.70%)、支气管肺发育异常症(2.70%)、早产儿脑室内出血(2.70%)、伴脑室周围白质软化(2.70%)、呼吸机相关性肺炎(5.41%)]与对照组进行比较差异无统计学意义(χ^2=1.347、1.347、1.057、0.001、1.347,P>0.05)。结论高频振荡通气法在改善呼吸窘迫综合征新生儿血气指标、潮气呼吸肺功能指标方面的效果优于间歇指令通气法,且能够缩短机械通气时间,促使并发症发生率降低。

Objective To study the effects of different mechanical ventilation methods on the complications of neonatal respiratory distress syndrome.Methods According to the order of admission,74 neonates with respiratory distress syndrome received by our hospital were convenient selected and divided into control group and observation group,37 cases/group,all received basic treatment,and then intermittent instruction ventilation method and highfrequency oscillation ventilation method were adopted.The clinical indicators of the two groups were compared.Results The arterial partial pressure of oxygen(71.23±6.15)mmHg and oxygen saturation(96.78±3.04)%after treatment of neonatal respiratory distress syndrome were higher than those of the control group,arterial carbon dioxide partial pressure(46.68±4.16)mmHg.Compared with the control group,the difference was statistically significant(t=5.444,4.236,5.512,P<0.05);the invasive ventilation time(74.50±30.22)h and non-invasive ventilation time(38.14±18.97)h in the observation group,the oxygen exposure time(151.36±33.49)h was shorter than that of the control group,and the difference was statistically significant(t=3.221,3.625,5.276,P<0.05);the heart rate of the newborn in the observation group(19.76±1.25)beats/min,lower than the control group,Ti(0.91±0.08)s,respiratory time(1.63±0.04)s were shorter than the control group,and tidal volume(9.93±1.28)mL/kg was higher than the control group,the difference was statistically significant(t=9.779,9.808,17.682,4.703,P<0.05);the incidence of complications in the observation group[lung air leak(2.70%),bronchopulmonary dysplasia(2.70%),intraventricular hemorrhage in premature infants(2.70%),with periventricular white matter softening(2.70%),ventilator-associated pneumonia(5.41%)]and control There was no statistically significant difference in the comparison between the groups(χ^2=1.347,1.347,1.057,0.001,1.347,P>0.05).Conclusion The high-frequency oscillatory ventilation method is better than the intermittent mandatory ventilation method in improving the blood gas index and tidal breathing pulmonary function index of neonates with respiratory distress syndrome,and can shorten the mechanical ventilation time and reduce the incidence of complications.