不同通气模式在呼吸窘迫综合征低体质量早产儿拔管撤机后的应用效果比较  

Effect of different ventilation modes on low birth weight premature infants with respiratory distress syndrome after extubation and weaning

作　　者：贾耀丽 赵惯军[1] 张矿召 Jia Yaoli;Zhao Guanjun;Zhang Kuangzhao(Department of Neonatal Intensive Care Unit,Pingdingshan First People’s Hospital,Pingdingshan 467000,China)

机构地区：[1]河南省平顶山市第一人民医院新生儿重症监护室,467000

出　　处：《中国实用医刊》2021年第12期49-52,共4页Chinese Journal of Practical Medicine

摘　　要：目的:探讨不同通气模式在呼吸窘迫综合征(RDS)低体质量早产儿拔管撤机后的应用效果。方法:抽取2018年5月至2020年5月平顶山市第一人民医院新生儿重症监护病房收治的低体质量早产儿RDS患儿100例,采用随机数字表法分为观察组(50例)和对照组(50例)。对照组采用经鼻间歇正压通气(NIPPV)治疗,观察组采用无创高频振荡通气(nHFOV)治疗。对比两组通气指标与无创呼吸支持治疗前(T1)、治疗24 h(T2)、治疗72 h(T3)时血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))及72 h内撤机率、并发症发生率。结果:两组无创辅助通气时间、总用氧时间比较,P>0.05;T2、T3时点,两组PaO_(2)水平不断升高,PaCO_(2)水平不断降低,且观察组PaO_(2)高于对照组,PaCO_(2)低于对照组,两组时点、组间、时点与组间交互比较,P<0.05;观察组72 h内撤机率高于对照组(P<0.05);两组频繁呼吸暂停、气漏、支气管肺发育不良、鼻损伤、脑室周围白质软化发生率比较,差异未见统计学意义(P>0.05)。结论:低体质量早产儿RDS患儿拔管撤机后,应用NIPPV、nHFOV治疗均可有效改善患儿通气状态,安全性相当,但nHFOV可更快恢复患儿血气状况,并提高72 h内撤机率。Objective To explore the effect of different ventilation modes on low birth weight premature infants with respiratory distress syndrome(RDS)after extubation and weaning.Methods A total of 100 cases of low birth weight premature infants with RDS admitted to Neonatal Intensive Care Unit of Pingdingshan First People’s Hospital from May 2018 to May 2020 were selected,and randomly divided into observation group(50 cases)and control group(50 cases).The control group was treated with nasal intermittent positive pressure ventilation(NIPPV),and the observation group was treated with non-invasive high frequency oscillatory ventilation(nHFOV).The ventilation indexes of the two groups before(T1),24 hours(T2)and 72 hours(T3)after noninvasive respiratory support and partial pressure of blood oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),the withdrawal probability within 72 hours and the incidence of complications were compared.Results The noninvasive auxiliary ventilation time and total oxygen consumption time ware compared between the two groups,P>0.05;at T2 and T3,the level of PaCO2 in the two groups increased and the level of PaCO2 decreased,and the PaO2 in the observation group was higher than that in the control group,while PaCO2 in the observation group was lower than that in the control group,the time point,inter group,time point and inter group interaction between the two groups were compared(P<0.05);the rate of withdrawal within 72 hours in the observation group was higher than that in the control group(P<0.05);there was no significant difference in the incidence of frequent apnea,air leakage,bronchopulmonary dysplasia,nasal injury,periventricular leukomalacia between the two groups(P>0.05).Conclusions Effect of extubation and weaning on RDS in low birth weight premature infants,NIPPV and nHFOV can effectively improve the ventilation status of low birth weight preterm infants with RDS,with similar safety.However,nHFOV can quickly recover the blood gas status of children,and increase the probability of weani

关 键 词：早产儿 呼吸窘迫综合征 无创高频振荡通气 经鼻间歇正压通气 

分 类 号：R722.6[医药卫生—儿科]