常规机械通气对低体重或超低体重新生儿脑损伤发生情况的影响  

Effects of conventional mechanical ventilation on the incidence of brain injury in low or ultra-low weight neonates

作　　者：田记旺 胡方启[1] TIAN Jiwang;HU Fangqi(Department of Pediatrics,Anqing Municipal Hospital,Anqing,Anhui 246000,China)

机构地区：[1]安庆市立医院儿科,安徽安庆246000

出　　处：《中国优生与遗传杂志》2021年第11期1633-1635,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨常规机械通气对低体重或超低体重新生儿脑损伤发生情况的影响。方法回顾性分析2017年10月—2019年12月本院收治行常规机械通气治疗的低或超低出生体重新生儿78例(机械通气组),同期选取本院住院未行机械通气治疗的78例低体重或超低体重新生儿为非机械通气组,比较两组研究对象脑损伤发生情况等。根据影像学及Paneth分类法将机械通气组患儿分为非脑实质出血组(n=36)、脑白质损伤组(n=21)及非脑损伤组(n=21),比较三组患儿呼吸机参数、血气指标及机械通气时间等。结果机械通气组患儿非脑实质出血、脑白质损伤及总脑损伤的发生率显著高于非机械通气组(P<0.05);非脑实质出血组患儿最高血氧分压(PaCO_(2))显著高于脑白质损伤组及非脑损伤组(P<0.05);脑白质损伤组患儿最低血氧分压(PaCO_(2))显著低于非脑实质出血组及非脑损伤组(P<0.05)。结论常规机械通气的非正常体重新生儿脑损伤的发生风险增高,在临床中应对机械通气患儿脑损伤情况进行密切观察。Objective To explore the effect of conventional mechanical ventilation on the occurrence of brain injury in newborns with low or ultra-low weight. Methods 78 cases of low or ultra-low weight neonates who were admitted to our hospital for routine mechanical ventilation from October 2017 to December 2019 were analyzed retrospectively and divided into the mechanical ventilation group. 78 patients who were admitted to our hospital at the same time without mechanical ventilation were non-mechanical ventilation group. The occurrence of brain damage between the two groups were compared. According to imaging and Paneth classification, the neonates in the mechanical ventilation group were divided into the non-cerebral parenchymal hemorrhage group(n=36), the white matter injury group(n=21) and the non-brain injury group(n=21). Ventilator parameters, blood gas indexes and mechanical ventilation time of the neonates in the three groups were compared. Results The incidence of non-parenchymal hemorrhage, white matter injury and total brain injury in the mechanical ventilation group was significantly higher than that in the non-mechanical ventilation group(P<0.05). The highest blood oxygen partial pressure(PaCO_(2)) in the non-cerebral parenchymal hemorrhage group was significantly higher than that in the white matter injury group and the non-cerebral injury group(P<0.05). The lowest blood oxygen partial pressure(PaCO_(2)) of neonates in the white matter injury group was significantly lower than that in the non-parenchymal hemorrhage group and the non-brain injury group(P<0.05). Conclusion Abnormal weight neonates with conventional mechanical ventilation have an increasing risk of brain injury, and should be closely observed in clinical practice.

关 键 词：机械通气 新生儿 脑损伤 脑室内出血 脑白质损伤 

分 类 号：R722.1[医药卫生—儿科]