PAV联合SIMV模式在新生儿呼吸窘迫综合征治疗中的应用  

Application of proportional assist ventilation combined with synchronized intermittent mandatory ventilation mode in the treatment of neonatal respiratory distress syndrome

作　　者：赵凤兰[1] 刘燕[1] ZHAO Feng-lan;LIU Yan(Department of Pediatrics,the First Affiliated Hospital of Xi’an Medical University,Xi’an 710077,Shaanxi,CHINA)

机构地区：[1]西安医学院第一附属医院儿科,陕西西安710077

出　　处：《海南医学》2019年第6期763-766,共4页Hainan Medical Journal

摘　　要：目的研究比例辅助通气(PAV)联合同步间歇指令通气(SIMV)模式在新生儿呼吸窘迫综合征中的治疗效果,为降低患儿罹患肺损伤寻求最佳方式。方法回顾性分析2014年1月至2017年1月西安医学院第一附属医院新生儿监护病房收治的50例呼吸窘迫综合征患儿的临床诊治资料,按照诊治方式的不同分为对照组25例和观察组25例。对照组给予SIMV模式治疗,观察组在对照组的基础上联合PAV模式治疗,比较两组患儿在安静状态下(0.5 h、12 h、24 h、48 h) 4个时间点发生人机对抗的次数、出现吸气峰压(PIP)次数、平均气道压(MAP)及出现低碳酸血症的发生率。结果观察组在4个时间点发生人机对抗次数、出现吸气峰压(PIP)次数、平均气道压(MAP)及发生低碳酸血症的发生率均明显低于对照组,且差异均有统计学意义(P<0.05)。结论 PAV联合SIMV模式在新生儿呼吸窘迫综合征中能更有效的达到人机同步的性能,有效降低出现吸气峰压次数及平均气道压,同时减少低碳酸血症的发生率。Objective To explore the therapeutic effect of proportional assist ventilation(PAV) combined with synchronized intermittent mandatory ventilation(SIMV) mode in neonatal respiratory distress syndrome(NRDS), and to find the best way to reduce the children suffering from lung injury. Methods The clinical data of 50 infants with respiratory distress syndrome, who admitted to the Neonatal Intensive Care Unit of the First Affiliated Hospital of Xi’an Medical University from January 2014 to January 2017, was retrospectively analyzed. According to the diagnosis and treatment, these patients were divided into the control group and the observation group, with 20 cases in each group. The control group was given SIMV model treatment, and the observation group was treated with PAV combined with SIMV mode. The times of man-machine confrontation, the times peak inspiratory(PIP), mean airway pressure(MAP), and the incidence of hypocarbonemia were compared between the two groups at 4 time points(0.5 h, 12 h, 24 h, 48 h) in quiet state. Results The times of man-machine confrontation, the PIP, MAP, and incidence of hypocarbonemia in the observation group were significantly lower than those in the control group at 4 time points(P<0.05). Conclusion PAV combined with SIMV model can achieve more effective human-machine synchronization in NRDS, effectively reduce the times PIP and MAP, and reduce the incidence of hypocarbonemia.

关 键 词：比例辅助通气 同步间歇指令通气 新生儿呼吸窘迫综合征 疗效 

分 类 号：R722.1[医药卫生—儿科]