不同通气方式联合牛肺表面活性剂对呼吸窘迫合并气胸新生儿动脉血气及呼吸力学的影响  

Effects of Different Ventilation Modes Combined with Bovine Lung Surfactant on Arterial Blood Gas and Breathing Mechanics of Neonates with Respiratory Distress Combined with Pneumothorax

作　　者：周曼丽[1] 黄玉焕[1] 吴靖[1] 张红阳 王东丽[1] ZHOU Manli;HUANG Yuhuan;WU Jing;ZHANG Hongyang;WANG Dongli(Department of Neonatal Intensive Care,the First People’s Hospital of Nanyang,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院新生儿重症监护科,河南南阳473000

出　　处：《河南医学研究》2021年第23期4291-4294,共4页Henan Medical Research

摘　　要：目的分析不同通气方式联合牛肺表面活性剂对呼吸窘迫合并气胸新生儿动脉血气及呼吸力学的影响。方法选择南阳市第一人民医院2013年4月至2019年8月收治的69例呼吸窘迫合并气胸新生儿作为研究对象,根据治疗方案分组,将接受常频机械通气(CMV)联合牛肺表面活性剂治疗的34例新生儿作为对照组,将接受高频振荡机械通气(HFOV)联合牛肺表面活性剂治疗的35例新生儿作为观察组。比较两组疗效、机械通气时间、动脉血气指标、呼吸力学指标。结果观察组治疗总有效率(91.43%)较对照组(58.82%)高(P<0.05)。观察组和对照组机械通气时间分别为(3.56±1.42)、(7.05±1.69)d,观察组机械通气时间较对照组短(P<0.05)。治疗6、12、24 h后,观察组动脉血氧分压(PaO2)较对照组高,动脉血二氧化碳分压(PaCO2)较对照组低,每分通气量(MV)、呼吸系统动态顺应性较对照组高,呼吸道阻力较对照组低(P<0.05)。结论HFOV联合牛肺表面活性剂治疗呼吸窘迫合并气胸新生儿效果较好,可有效缩短机械通气时间,改善动脉血气和呼吸力学指标。Objective To analyze the effects of different ventilation modes combined with bovis lung surfactant on arterial blood gas and breathing mechanics of neonates with respiratory distress complicated with pneumothorax.Methods Sixty-nine neonates with respiratory distress combined with pneumothorax in the First People’s Hospital of Nanyang from April 2013 to August 2019 were selected and grouped according to the treatment plan.Thirty-four patients who received regular mechanical ventilation(CMV)combined with bovine lung surface active agent were selected as control group,and the other 35 patients who received high frequency oscillating mechanical ventilation(HFOV)combined with bovine lung surfactant were selected as observation group.Therapeutic effect,mechanical ventilation time,arterial blood gas indexes and respiratory mechanics were compared between the two groups.Results The total effective rate of observation group was higher than that of control group(91.43%vs.58.82%,P<0.05).The mechanical ventilation time of observation group and control group were(3.56±1.42)and(7.05±1.69)days,respectively.The mechanical ventilation time of observation group was shorter than that of control group(P<0.05).After 6,12,and 24 hours of treatment,in observation group,the arterial partial pressure of oxygen(PaO2)was higher than that ni control group,the arterial partial pressure of carbon dioxide(PaCO2)was lower than that in control group,minute ventilation(MV)and the dynamic compliance were higher than those in control group,and the airway resistance was lower than that in control group(P<0.05).Conclusion HFOV combined with bovine lung surfactant is more effective in the treatment of neonates with respiratory distress and pneumothorax,which could effectively shorten the time of mechanical ventilation and improve arterial blood gas and respiratory mechanics.

关 键 词：呼吸窘迫 气胸 新生儿 高频振荡机械通气 牛肺表面活性剂 

分 类 号：R725.6[医药卫生—儿科]