经鼻同步间歇指令通气疗法对NRDS患儿动脉血气分析指标、并发症及撤机成功率的影响  

Effects of transnasal synchronous intermittent mandatory ventilation on arterial blood gas analysis indexes,complications and weaning success rate in children with NRDS

作　　者：赵锦英 蒋晓梅 梁秋荣 Zhao Jin-ying;Jiang Xiao-mei;Liang Qiu-rong(Department of Neonatology,Laibin People’s Hospital,Laibin 546100,China)

机构地区：[1]来宾市人民医院新生儿科,来宾546100

出　　处：《湖南师范大学学报（医学版）》2022年第3期74-78,共5页Journal of Hunan Normal University(Medical Sciences)

基　　金：2019年来宾市科学研究与技术开发计划项目(193314)。

摘　　要：目的:观察呼吸窘迫综合征(NRDS)患儿给予经鼻同步间歇指令通气(nSIMV)疗法对其动脉血气分析指标、并发症及撤机成功率的影响.方法:选择本院2019年9月~2021年8月新生儿科住院需给予呼吸支持治疗的NRDS患儿104例加以研究,随机数字表法分作对照组及治疗组各52例,对照组给予经鼻持续气道正压通气(nCPAP)疗法,治疗组给予nSIMV疗法;比较两组疗效,包含治疗总有效率、动脉血气分析指标[氧合指数(OI)、呼吸指数(RI)、动脉二氧化碳分压(PaCO_(2))、动脉氧分压(PaO_(2))、pH及乳酸]、并发症发生率、撤机成功率、治疗结束时呼吸机参数(吸气时间、吸气峰压、呼气末正压)、上机时间、氧疗时间、住院时间,以评价nSIMV的优势.结果:治疗3d后,治疗组总有效率高于对照组.治疗24h后,治疗组OI、PaO_(2)以及pH指标均显著高于对照组;治疗组RI、PaCO_(2)、乳酸水平指标明显低于对照组.治疗组并发症总发生率明显低于对照组.治疗组撤机成功率明显高于对照组.治疗结束时,两组吸气时间比较差异无统计学意义;与对照组相比,治疗组吸气峰压、呼气末正压更低,上机时间、氧疗时间、住院时间更短.结论:nSIMV疗法相对nCPAP疗法疗效更显著,能有效改善NRDS患儿动脉血气分析指标和呼吸机参数,降低并发症的发生率,提高撤机成功率.Objective To analyze the effects of transnasal synchronous intermittent mandatory ventilation(nSIMV)on arte-rial blood gas analysis indexes,complications and weaning success rate in children with respiratory distress syndrome(NRDS).Methods 104 children with NRDS who were hospitalized in neonatal Pediatrics from September 2019 to August 2021 were randomly divided into control group and treatment group.The control group was treated with nasal continuous positive airway pressure ventilation(nCPAP)and the treatment group was treated with nSIMV;The curative effects of the two groups were com-pared,including the total effective rate,arterial blood gas analysis indexes[oxygenation index(OI),respiratory index(RI),arte-rial carbon dioxide partial pressure(PaCO_(2)),arterial oxygen partial pressure(PaO_(2)),pH and lactic acid],the incidence of com-plications,the success rate of weaning,ventilator parameters at the end of treatment(inspiratory time,peak inspiratory pressure,positive end-expiratory pressure),machine time,oxygen treatment time and hospital stay,so as to evaluate the advantages of nSIMV.Results after 3 days of treatment,the total effective rate in the treatment group was significantly higher than that in the control group.After 24 hours of treatment,OI,PaO_(2) and pH in the treatment group were significantly higher than those in the control group;The index of PaCO_(2) in the treatment group was significantly lower than that in the control group.The total inci-dence of complications in the treatment group was significantly lower than that in the control group.The success rate of weaning in the treatment group was significantly higher than that in the control group.At the end of treatment,there was no significant difference in inspiratory time between the two groups;Compared with the control group,the peak inspiratory pressure and posi-tive end expiratory pressure in the treatment group were lower,and the machine time,oxygen treatment time and hospital stay were shorter in the treatment group.Conclusion nSIMV th

关 键 词：呼吸窘迫综合征 经鼻同步间歇指令通气 动脉血气分析指标 并发症 撤机成功率 

分 类 号：R725.6[医药卫生—儿科]