俯卧位机械通气对呼吸衰竭新生儿氧合指数的影响  

Effect of Prone Position Mechanical Ventilation on Oxygenation Index in Neonatal Respiratory Failure

作　　者：吴杰斌[1] 蒋红侠 许红[2] 李传景[2] 田贞尚[3] 

机构地区：[1]江苏省徐州市中心医院,江苏徐州221009 [2]安徽省宿州市立医院,安徽宿州234000 [3]安徽省宿州卫生学校,安徽宿州234000

出　　处：《儿科药学杂志》2013年第3期6-9,共4页Journal of Pediatric Pharmacy

摘　　要：目的:研究俯卧位机械通气对新生儿呼吸功能的改善以及对新生儿呼吸衰竭氧合指数(OI)的影响。方法:研究对象为2011年1月至2012年2月徐州市中心医院和宿州市立医院新生儿重症监护室收治给予机械通气治疗的呼吸衰竭新生儿51例,随机分为仰卧位组26例和俯卧位组25例,分别对两组1 h、6 h时呼吸机参数、氧合指标、肺力学参数以及撤机时间、撤机后1 h动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)进行对比分析。结果:俯卧位组1 h PaO2为(66.37±8.54)mm Hg,6 hPaO2为(68.42±10.43)mm Hg,分别较仰卧位组1 h PaO2的(61.22±9.43)mm Hg和6 h PaO2的(62.60±11.36)mm Hg明显增高,差异有统计学意义(P<0.05);俯卧位组1 h OI(OI=PaO2/FiO2)为(167.88±26.97)mm Hg,6 h OI为(170.84±19.82)mm Hg,分别高于仰卧位组的1 h OI(151.66±21.04)mm Hg和6 h OI(156.94±23.51)mm Hg,两组比较差异有统计学意义(P<0.05);仰卧位组与俯卧位组撤机时间以及撤机后1 h PaCO2、PaO2变化相似,两组比较差异无统计学意义(P>0.05)。结论:俯卧位机械通气治疗新生儿呼吸衰竭与传统仰卧位相比,能更好地改善患儿呼吸衰竭症状,提高氧合指数。Objective： To evaluate the effect of prone position mechanical ventilation on the improvement of respiratory function and oxygenation index in neonatal respiratory failure. Methods： Fifty one newborn infants of respiratory failure treated by mechanical ventilation in neonatal intensive eare unit （NICU） of Xuzhou Central Hospital and Suzhou Municipal Hospital from January 2011 to February 2012 were randomly divided into a supine group （n=26） and a prone group （n=25）. The results within one hour and six hour ventilator parameters, Oxygenation index OI （ OI = PaO2/FiO2 ） , the lung mechanics parameters and ventilator weaning-time, arterial carbon dioxide partial pressure （ PaCO2 ） and arterial oxygen tension （ PaO2 ） one hour after ventilator weaning were recorded and compared in the two groups. Results： PaO2 in the prone position ventilation group within one hour （66.37±8.54） mm Hg and six hour （68.42±10.43） mm Hg were higher correspondingly than that in the supine position ventilation group within one hour （61.22±9.43） mm Hg and six hour （62.60±11.36） mm Hg; the difference was statistically significant （P〈0.05）. Calculation of OI within one hour and six hour was （167.88±26.97） mm Hg and （170.8±19.82） mm Hg in the prone group, which were higher than that within one hour （151.66±21.04） mm Hg and six hour （156.94±23.51） mm Fig in the supine group correspondingly; the difference was statistically significant （ P〈0.05 ）. The ventilator weaning-time, and the changes of PaCO2 and PaO2 one hour after ventilator weaning of the two groups were similar and the difference was not statistically significant （P 〉 0.05 ）. Conclusions： Compared with traditional supine position, treating neonatal respiratory failure with prone position ventilation can improve the symptoms of respiratory failure and oxygenation index significantly.

关 键 词：俯卧位通气 氧合指数 呼吸衰竭 新生儿 

分 类 号：R722.1[医药卫生—儿科]