同步间歇指令通气联合压力支持通气模式治疗新生儿呼吸窘迫综合征对患儿呼吸与氧合功能及呼吸机相关并发症的影响  

Effect of synchronous intermittent mandatory ventilation combined with pressure support ventilation mode on respiratory and oxygenation function and ventilator-related complications in children with neonatal respiratory distress syndrome

作　　者：朱日 易飞 黄荷 ZHU Ri;YI Fei;HUAGN He(Department of Neonatology,Yichun People's Hospital,Yichun,Jiangxi,336000,China)

机构地区：[1]宜春市人民医院新生儿科,江西宜春336000

出　　处：《当代医学》2024年第14期22-25,共4页Contemporary Medicine

摘　　要：目的探究同步间歇指令通气(SIMV)联合压力支持通气(PSV)模式治疗新生儿呼吸窘迫综合征(NRDS)对患儿呼吸、氧合功能及呼吸机相关并发症的影响。方法选取2020年1月至2021年4月宜春市人民医院收治的60例NRDS患儿作为研究对象,根据治疗方式的不同分为联合组与SIMV组,每组30例。SIMV组采用SIMV机械通气,联合组在SIMV组基础上联合PSV,比较两组出生后呼吸情况、不同时间[机械通气后3 h(T_(0))、机械通气后12 h(T_(1))、撤机前(T_(2))]呼吸功能[吸气峰压(PIP)、每分钟通气量(MV)、呼吸频率(RR)]、血氧指标[平均气道压(MAP)、二氧化碳分压(PaCO_(2))]及人机对抗次数、并发症发生率。结果联合组机械通气时间、补氧时间、脱机时间均短于SIMV组,差异有统计学意义(P<0.05);两组出院时间、死亡占比比较差异无统计学意义。T_(1)、T_(2)时,两组PIP、MV、RR均低于前一时间点,差异有统计学意义(P<0.05)。T_(0)、T_(1)时,两组PIP、MV、RR比较差异无统计学意义;T_(2)时,联合组PIP、MV、RR均低于SIMV组,差异有统计学意义(P<0.05)。T_(1)、T_(2)时,两组MAP、PaCO_(2)均低于前一时间点,人机对抗次数少于前一时间点,差异有统计学意义(P<0.05)。T_(0)、T_(1)时,两组MAP、Pa-CO_(2)、人机对抗次数比较差异无统计学意义;T_(2)时,联合组MAP、PaCO_(2)均低于SIMV组,人机对抗次数少于SIMV组,差异有统计学意义(P<0.05)。联合组并发症发生率为10.00%,低于SIMV组的33.33%,差异有统计学意义(P<0.05)。结论SIMV联合PSV模式能帮助NRDS患儿缩短机械通气治疗时间,提高患儿自主呼吸能力,并通过改善其呼吸、氧合功能减少患儿呼吸机相关并发症,临床价值较高。Objective To explore the effects of synchronous intermittent mandatory ventilation(SIMV)combined with pressure support ventilation(PSV)mode on respiratory and oxygenation functions and ventilator-related complications in children with neonatal respiratory distress syndrome(NRDS).Methods 60 children with NRDS admitted to Yichun People's Hospital from January 2020 to April 2021 were selected as the research subject,and they were divided into the combined group and the SIMV group according to different treatment methods,with 30 cases in each group.The SIMV group was mechanically ventilated by SIMV,and the combined group was combined with PSV on the basis of the SIMV group.The respiratory conditions,respiratory function(peak inspiratory pressure[PIP],ventilate volume per minute[MV],respiratory rate[RR])and blood oxygen index(mean airway pressure[MAP]at different times(3 h after mechanical ventilation[T_(0)],12 h after mechanical ventilation[T_(1)],before withdrawal[T_(2)]),partial pressure of carbon dioxide in arterial blood[PaCO_(2)]),man-machine confrontation times and complication rate were compared between the two groups.Results The mechanical ventilation time,oxygen supplementation time and offline time in the combined group were shorter than those in the SIMV group,and the differences were statistically significant(P<0.05);there was no significant difference in discharge time and death proportion between the two groups.At T_(1) and T_(2),the PIP,MV and RR of the two groups were lower than those at the previous time point,and the differences were statistically significant(P<0.05);at T_(0) and T_(1),there was no significant difference in PIP,MV and RR between the two groups;at T_(2),PIP,MV and RR in the combined group were lower than those in the SIMV group,and the differences were statistically significant(P<0.05).At T_(1) and T_(2),the MAP and PaCO_(2)of the two groups were lower than those at the previous time point,and the number of man-machine confrontations was less than that at the previous time point,the

关 键 词：同步间歇指令通气 压力支持通气 新生儿呼吸窘迫综合征 

分 类 号：R722.1[医药卫生—儿科]