不同通气模式对新生儿胎粪吸入综合征血流动力学的影响  

Effect of different mechanical ventilation modes on cardiac function in infants with meconium aspiration syndrome

作　　者：陈虹余[1] 邱其周[1] 程贵辉[1] 熊伟[1] 梁菊芳[1] 肖毅[1] 

机构地区：[1]广州医科大学附属深圳沙井医院,广东深圳518104

出　　处：《现代中西医结合杂志》2016年第5期467-469,472,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：2015年深圳市宝安区科技创新局资助项目(2015205)

摘　　要：目的探讨不同机械通气模式对新生儿胎粪吸入综合征血流动力学的影响。方法将符合纳入排除标准的58例需要机械通气的新生儿胎粪吸入综合征患儿随机分为高频振荡通气组(HFOV组)和常频机械通气组(CMV组),每组29例。2组均于上机治疗前及上机治疗后每隔2 h监测并记录血气分析、心率、血氧饱和度[Sp(O_2)]、血压、搏动指数(PI),同时行床边心脏彩超测射血分数(EF)、每搏量(SV)。结果 2组通气后各时间点血气分析均较通气前明显改善,Sp(O_2)、血压较通气前好转(P均<0.05),心率、PI、EF及SV无明显改变;2组通气后各时间点各指标比较差异均无统计学意义(P均>0.05)。结论高频振荡通气和常频机械通气均可明显改善新生儿胎粪吸入综合征患儿的血气分析,且对血流动力学影响无明显差异,效果相近。如何选择最佳治疗新生儿胎粪吸入综合征的通气模式,需结合临床转归进一步研究。Objective It is to investigate the effect of different mechanical ventilation modes on cardiac function in infants with meconium aspiration syndrome（ MAS）. Methods 58 MAS infants were randomly assigned into high- frequency oscillation ventilation（ HFOV） group and conventional mechanical ventilation（ CMV） group,each group had 29 cases. Blood gas analysis and heart rate（ HR）,blood oxygen saturation [Sp（O2） ],blood pressure（ BP）,pulse index（ PI） were detected and recorded before mechanical ventilation and at every 2 h after ventilation,at the same time line test bed heart colour was used to detect ejection fraction（ EF）,stroke volume（ SV）. Results Blood gas analysis indexes,and HR,Sp（O2）,BP,PI,EF,SV were all improved significantly at every time point after ventilation compared with those before,and the differences in the indexes above were not significantly different between the two groups（ P all 〉 0. 05）. Conclusion Both ventilation modes of HFOV and CMV can obviously improve hemodynamic in the infants with MAS,and the effects between the two modes are the same.How to choose the most superior mode to treatment for MAS need to combine the clinical outcome for further observation.

关 键 词：高频通气 常频通气 新生儿胎粪吸入综合征 血流动力学 

分 类 号：R722.1[医药卫生—儿科]