允许性高碳酸血症对新生儿呼吸窘迫综合征外周血炎症介质的影响  

Effects of permissive hypercapnia on inhibiting inflammatory mediators into plasma in respiratory distress syndrome of neonates

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作  者:杨秀芳[1] 郑铠军[1] 夏荣华[1] 陈敬国[1] 陈简[1] 黄惠娟[1] 

机构地区:[1]广东省中山市人民医院儿科监护室,528400

出  处:《中国医师进修杂志》2006年第11期6-8,共3页Chinese Journal of Postgraduates of Medicine

摘  要:目的探讨允许性高碳酸血症进行观察的肺保护性通气策略应用价值,观察其对患儿外周血中炎症介质的影响。方法将60例新生儿呼吸窘迫综合征需应用呼吸机支持治疗的患儿随机分为两组:试验组行肺保护性通气策略共30例,对照组应用传统通气策略(大潮气量通气)共30例。动态观察两组患儿外周血中炎症介质在治疗前后的变化。结果应用两种策略治疗后,两组炎症介质水平均有不同程度的降低的肺保护性通气策略(P均<0.05);但应用传统通气策略治疗的效果不如应用允许性高碳酸血症的肺保护性通气策略(P<0.05)。结论应用两种策略治疗新生儿呼吸窘迫综合征对减少炎症介质的释放均有不同程度的作用;而应用允许性高碳酸血症的肺保护性通气策略具有更好的效果。Objective To observe the changes in inflammatory mediators in plasma in respiratory distress syndrome(RDS) of neonates received lung protective ventilation treatment. Methods Sixty newboi'n infants,diagnosed as RDS of neonatal and needed ventilator support, were recruited from the intensive care unit from May 2003 to May 2006. Infant with RDS were randomly divided into two groups. Both had 30 newborn infants. The infants in the experimental groups received lung protective ventilation treatment tidal volume :5 - 8 ml/kg, positive end - expiratory pressure (PEEP) :0.51- 0.98 kPa, and the control groups received large tidal volume ventilation ( tidal volume: 10 - 15 ml/kg, PEEP: 0 - 0. 29 kPa). The contents of TNF - α, interleukin - 6 in plasma were measured. Results After those two therapies, the contents of tumor necrosis factor- α( TNF- α), interleukin- 6 in plasma decreased obviously, especially after receiving lung protective ventilation treatment. Conclusions There are statistical differences in the amount of inflammatory mediators released between the experimental group under lung protective ventilation treatment and the control group received large tidal volume ventilation, and better effects are seen in RDS infants under lung protective ventilation treatment.

关 键 词:允许性高碳酸血症 新生儿 呼吸窘迫综合征 炎症介质 

分 类 号:R722.1[医药卫生—儿科]

 

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