目标容量控制通气在新生儿胎粪吸入综合征中的应用  

The Application of the Targeted Tidal Volume Ventilation in Meconium Aspiration Syndrome

作　　者：刘雪琴[1] 张卫星[1] 刘玉霞[1] 赵宝君[1] 

机构地区：[1]新乡市中心医院新生儿科,河南新乡453000

出　　处：《中外医疗》2015年第19期17-19,共3页China & Foreign Medical Treatment

摘　　要：目的比较目标容量控制通气(TTV)和辅助/控制通气(A/C)在新生儿胎粪吸入综合征(MAS)治疗中的效果和并发症的发生。方法随机选择2012年6月—2015年2月新乡市中心医院收治的MAS患儿60名,随机分成TTV组和对照组,各30例。TTV组采用TTV+同步间歇指令通气(SIMV)+压力支持通气(PSV)治疗MAS,对照组采用A/C治疗MAS,比较两组患儿治疗后动脉氧分压/吸入氧浓度(Pa O2/Fi O2)、动脉氧分压/肺泡氧分压(Pa O2/PAO2)的变化和并发症发生情况。结果两组患儿治疗后Pa O2/Fi O2、Pa O2/PAO2明显升高差异有统计学意义(P<0.05),与对照组相比,TTV组患儿治疗后Pa O2/Fi O2、Pa O2/PAO2明显升高差异有统计学意义(P<0.01)。TTV组患儿与对照组相比,呼吸机相关性肺炎和肺气漏发生率明显减少差异有统计学意义(P<0.05)。两组患儿死亡率差异无统计学意义(P>0.05)。结论 TTV+SIMV+PSV可以更快改善MAS患儿的氧合,疗效优于A/C模式,减少了呼吸机相关性肺炎和肺气漏的发生率。Objective The treatment effects and complications between the targeted tidal volume ventilation （TTV） and auxiliary/control ventilation （A/C） in the neonatal meconium aspiration syndrome （MAS） are compared. Methods Sixty neonates with MAS between June 2012 and February 2015 in Xinxiang Central Hospital, were randomly divided into TTV group and the control group, 30 cases in each. Changes and complications on partial pressure of arterial oxygen/fraction of inspired oxygen （PaO2/FiO2）, and partial pressure of arterial oxygen/partial pressure of alveolar oxygen （PaO2/PAO2） were compared after treatment between the two groups, in which TTV group being treated for MAS by TTV ＋ synchronized intermittent mandatory ventilation （SIMV） ＋ pressure support ventilation （PSV）, while the control group by A/C mode. Results After treatment in two group neonates data on PaO2/FiO2 and PaO2/PAO2 were significantly higher （P〈0.05）. Compared neonates with the control group, after treatment, PaO2/FiO2 and PaO2/PAO2 of TTV group increased significantly （P〈0.01）. Compared with the control group of neonates, TTV group with ventilator-asso-ciated pneumonia and lung leakage rate decreased significantly （P〈0.05）. Mortality Two groups of neonates was no significant dif-ference （P〉0.05）. Conclusion Ventilation of TTV＋SIMV＋PSV can quickly improve oxygenation in neonates with MAS, the curative effect is better than that of A/C mode, and the ventilator-associated pneumonia and lung leakage rate are to be reduced.

关 键 词：目标容量通气 新生儿胎粪吸入综合征 辅助/控制通气 

分 类 号：R47[医药卫生—护理学]