机械通气治疗新生儿呼吸衰竭43例的临床观察  

Clinical Analysis of Mechanical Ventilation in 43 Neonates with Respiratory Failure

作　　者：吴琪[1] 武荣[1] 金桂红[1] 熊言佳[1] 周海燕[1] 

机构地区：[1]安徽省滁州市第一人民医院儿科,239000

出　　处：《中华全科医学》2011年第9期1382-1383,共2页Chinese Journal of General Practice

摘　　要：目的观察机械通气治疗新生儿呼吸衰竭的效果。方法对43例符合新生儿呼吸衰竭的患儿给予机械通气,重度窒息11例,肺炎17例,颅内出血5例,肺透明膜病8例,胎粪吸入综合症10例,重度缺氧缺血脑病1例,频繁呼吸暂停1例,先天性心脏病4例,败血症伴循环衰竭3例。根据具体疾病的特点和病情变化选择合适的通气模式和参数。结果抢救成功32例(74.4%),放弃8例(18.6%),死亡3例(6.98%)。机械通气并发呼吸机相关性肺炎11例。8例次气管分泌物培养阳性。放弃的8例中,其中4例(因经济等原因)系MAS、低出生体重儿治愈可能性很大。结论熟练掌握小儿机械通气的呼吸力学知识、通气模式和参数调节,适时尽早上机,尽量使用较低PEEP、PIP、较短的吸气时间,尽快脱机,严格无菌操作,防止感染,是机械通气治疗新生儿呼吸衰竭成功的关键。Objective To investigate the effects mechanical ventilation on neonatal respiratory failure. Methods The mechanical ventilation were performed in 43 neonates with respiratory failure, in which there were 11 cases of severe asphyxia, 17 cases of pneumonia,5 cases of intracranial hemorrhages,8 cases of hyaline membrane disease,10 cases of meconium aspiration syndrome （MAS） ,1 case of severe hypoxic-ischemic encephalopathy,l case of frequent apnea,4 cases of congenital heart disease,3 cases of septicaemia with circulatory failure. The mechanical ventilation mode and parameters were adjusted according to the characteristics and conditions of specific diseases. Results The successful rescue were carried out in 32 of 43 neonates（74.4% ） ,8 cases gave up（ 18.6% ） , and 3 cases died. There were 11 cases of ventilator-associated pneumonia ,8 cases with positive results in the culture of trachea secretion. In the 8 abandoned cases（ most from economic reason） were MAS or low birth weight new born that could be very possibly cured. Conclusion The skillful operation of mechanical, proper setting of mode and parameter, timely and proper use of mechanical ventilation, low PEEP and PIP, short ventilation duration, strict aseptic technique and infection prevention should significantly improve the survival rate of neonates with respiratory failure.

关 键 词：新生儿 呼吸衰竭 机械通气 

分 类 号：R722.1[医药卫生—儿科]