BIPAP与SIMV对呼吸衰竭患儿有创机械通气治疗效果的影响

Influence of BIPAP and SIMV on Curative Effect of Invasive Mechanical Ventilation in Vhildren with Respiratory Failure

目的:探讨双水平气道正压通气(BIPAP)与同步间歇指令式通气(SIMV)对呼吸衰竭患儿有创机械通气治疗效果的影响。方法:选取2019年9月-2021年8月在某院收治的80例呼吸衰竭住院患儿作为研究对象,采用随机数表法将所有呼吸衰竭患儿分为观察组和对照组各40例,对照组采用SIMV通气方式进行治疗,观察组在SMIV通气30min之后改用BIPAP通气方式。记录观察组和对照组患儿的有创通气时间、呼吸机相关性肺炎(VAP)发生率、住ICU时间及院内病死率。治疗前后,记录观察组和对照组患儿的心率、呼吸频率和pH值,利用血气分析仪监测患儿的吸氧分数(FiO_(2)),计算氧合指数(OI)和动脉肺泡氧分压比(a/A PaO_(2))指数。结果:观察组呼吸衰竭患儿的有创通气时间及住ICU时间明显短于对照组(P<0.05);治疗后,观察组患儿的心率明显高于对照组,呼吸频率明显低于对照组(P<0.05);治疗后,观察组患儿的FiO_(2)、OI指数均明显低于对照组(P<0.05),治疗后观察组患儿的a/A PaO_(2)指数明显高于对照组(P<0.05)。观察组呼吸衰竭患儿的VAP发生率和院内病死率分别为12.50%和7.50%,与对照组的25.00%和12.50%比较无明显差异(P>0.05)。结论:相比于SMIV通气方式,BIPAP有创机械通气对呼吸衰竭患儿的抢救治疗具有更好的效果。

Objective:To explore the influences of bi-level positive airway pressure(BIPAP)and synchronized intermittent mandatory ventilation(SIMV)on curative effect of invasive mechanical ventilation in children with respiratory failure.Methods:A total of 80 children with respiratory failure admitted to a hospital from September 2019 to August 2021 were enrolled and divided into observation group and control group according to random number table method,with 40 cases in each group.The control group was treated with SIMV,while the observation group was treated with BIPAP after 30 minutes of SMIV.The invasive ventilation time,incidence of ventilator-associated pneumonia(VAP),stay time in ICU,nosocomial mortality,heart rate,respiratory rate and pH value before and after treatment in both groups were recorded.The fraction of inspired oxygen(FiO_(2))was monitored by blood gas analyzer,and the oxygenation index(OI)and ratio of arterial alveolar oxygen partial pressure(a/A PaO_(2))index were calculated.Results:The invasive ventilation time and stay time in ICU in observation group were significantly shorter than those in control group(P<0.05).After treatment,heart rate in observation group was significantly higher than that in control group,while respiratory rate was significantly lower than that in control group(P<0.05).After treatment,FiO_(2) and OI in observation group were significantly lower than those in control group(P<0.05),while a/A PaO_(2) index was significantly higher than that in control group(P<0.05).The incidence of VAP and nosocomial mortality in observation group were 12.50% and 7.50%,respectively,and compared with 25.00% and 12.50% in the control group,there was no significant difference(P>0.05).Conclusion:Compared with SMIV,the curative effect of BIPAP is better on children with respiratory failure in invasive mechanical ventilation.