PRVC模式和压力控制SIMV模式治疗新生儿呼吸窘迫综合征的疗效及安全性比较  

Efficacy and safety comparison between PRVC and SIMV in treatment of neonates with respiratory distress syndrome

作　　者：杨军[1] 台晓燕[2] 

机构地区：[1]安徽省蚌埠市第二人民医院儿科,233000 [2]蚌埠医学院第一附属医院儿科,安徽蚌埠233000

出　　处：《淮海医药》2016年第1期15-17,共3页Journal of Huaihai Medicine

摘　　要：目的:比较压力调节容量控制通气(PRVC)模式和同步间歇指令通气(压力控制SIMV)模式对新生儿窘迫综合征(NRDS)的治疗效果及安全性。方法:选取2014年5月-2015年5月收住我院及蚌埠医学院第一附属医院儿科50例患有RDS且需要呼吸支持的新生儿,随机分为SIMV(PSV+PCV)组和PRVC组,观察2组患儿年龄、性别、机械通气动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2),p H值,机械通气的气道峰压,氧合指数以及机械通气后相关并发症,比较上述指标之间的差异。结果:2组患儿胎龄,体重,机械通气的相关并发症如气胸、支气管肺发育不良,颅内出血,呼吸机相关性肺炎之间比较差异无统计学意义(P>0.05),2组患儿通气后呼吸力学方面:机械通气的气道峰压比较差异有统计学意义(P<0.05),平均气道压和氧合指数比较差异无统计学意义(P>0.05);血气分析结果 p H,Pa O2,Pa CO2PRVC组均低于SIMV(PSV+PCV)组,差异有统计学意义(P<0.05)。结论:对于新生儿呼吸窘迫综合征的治疗,使用PRVC模式机械通气时气道峰压低于使用压力控制SIMV模式,且改善氧合的作用优于容控SIMV模式,故PRVC模式较压力控制SIMV模式更为安全有效的一种通气模式。Objective： To compare the efficacy and related complications in neonates with respiratory distress syndrome（ RDS） treated by pressure regulated volume control ventilation（ PRVC） and pressure controlled synchronized intermittent mandatory ventilation（ SIMV）. Methods： 50 cases of newborns with RDS and respiratory support between May 2014 and May 2015 were selected and randomly divided into a SIMV and a PRVC group. The two groups of children were observed and compared in terms of age,sex,mechanical ventilation arterial blood oxygen partial pressure（ Pa O2）,arterial partial pressure of carbon dioxide（ Pa CO2）,PH value,the airway peak pressure of mechanical ventilation and oxygenation index. And the differences between the above indicators caused by related complications after mechanical ventilation were also compared. Results： There was no statistically significant difference between the two groups as for gestational age,weight,related complications such as pneumothorax,bronchial pulmonary hypoplasia,intracranial hemorrhage,and ventilator associated pneumonia（ P〈0. 05）. Respiratory mechanics indicated that the comparative difference of mechanical ventilation airway peak pressure was statistically significant（ P〈0. 05）,and mean airway pressure and oxygenation index were of no statistical significance（ P〈0. 05）. Blood gas analysis showed that p H,Pa O2,and Pa CO2 of the PRVC group were lower than those of the SIMV（ PSV＋ PCV） group（ P〈0. 05）,with statistical significance. Conclusion： For the treatment of neonatal RDS,the mechanical ventilation airway peak pressure by using PRVC mode may be lower than using pressure control SIMV mode,and can better improve the oxygenation function. So the PRVC mode may be safer and more effective.

关 键 词：呼吸窘迫综合征 新生儿 压力调节容量控制通气 压力控制同步间歇指令通气 

分 类 号：R722.12[医药卫生—儿科]