有创-无创序贯性通气治疗新生儿呼吸衰竭的临床研究  

Sequential invasive-noninvasive mechanical ventilation in neonatal respiratory failure

作　　者：张国英[1] 郑静[1] 王晓蕾[1] 魏艳[1] 张兴圆[1] 何伟[1] 廖霓[1] 樊映红[1] 

机构地区：[1]成都市儿童医院,610017

出　　处：《中国小儿急救医学》2007年第5期400-403,共4页Chinese Pediatric Emergency Medicine

基　　金：2006年度四川省卫生厅科研资助项目(060180);四川省成都市卫生局学术和技术带头人及培养对象培养资金资助项目(2006-61)

摘　　要：目的研究新生儿呼吸衰竭患儿的撤机过程中,采用有创-无创序贯性通气能提高撤机的成功率。方法将34例新生儿呼吸衰竭患儿随机分成两组,17例患儿接受有创-无创序贯通气治疗为治疗组,17例患儿接受传统脱机治疗为对照组,比较两组的撤机成功率、总用氧时间,并同时观察两组患儿的呼吸暂停及漏斗胸的患病率。结果治疗组与对照组的撤机成功率分别为94.1%和70.6%(P<0.05);总用氧时间分别为(15±6)d和(21±8)d(P<0.05);呼吸暂停的患病率分别为5.9%和23.5%(P<0.05);漏斗胸的患病率分别为0和17.6%(P<0.05)。结论使用有创-无创序贯性通气模式治疗新生儿呼吸衰竭较传统脱机模式更有效,提高了撤机成功率,并降低了并发症的发生率。Objective Many controversial questions remain concerning the best methods for conducting the weaning process from mechanical support and from the endotracheal tube. We aimed to assess whether se- quential invasive-noninvasive mechanical ventilation can increase the weaning success rate and improve the out- comes of patients with neonatal respiratory failure（NRF） compared with conventional mechanical ventilation. Methods A prospective randomized trial was conducted at the intensive care unit（ICU） over 2 years included 34 patients with NRF. Thirty-four patients were randomly assigned to therapy group （n = 17） and control group（ n = 17）, the therapy group was treated by sequential invasive-noninvasive mechanical ventilation and the control group was treated by conventional weaning mode. The two groups were compared by determing the weaning success rate, time of oxygen requirement and the incidence of apnea and funnalchest. Results The weaning success rate was 94.1% in therapy group versus 70.6 % in control group（ P 〈 0.05 ）. The time of oxygen requirement was （15 ± 6）days in therapy group versus （21 ± 8 ）days in control group（ P 〈 0.05）. The incidence of apnea and funnalchest were 5.9 % and 0 in therapy group versus 23.5 % and 17.6 % in control group（P〈 0.05）. Conclusion Compared with conventional weaning from mechanical ventilation, Sequential invasive-noninvasive mechanical ventilation is more effective in treating patients with NRF. It can increase the weaning success rate and decrease complications of patients.

关 键 词：婴儿 新生 呼吸衰竭 持续气道正压通气 有创通气 

分 类 号：R722.1[医药卫生—儿科]