不同通气模式在呼吸衰竭新生儿机械通气治疗中的作用  

Effect of different ventilation modes in neonatal mechanical ventilation treatment of neonates with respiratory failure

作　　者：付婷 辛亚伟 何强明 FU Ting;XIN Yawei;HE Qiangming(Department of Neonatology,First People's Hospital of Fuzhou City,Fuzhou,Jiangxi,344000,China)

机构地区：[1]抚州市第一人民医院新生儿科,江西抚州344000

出　　处：《当代医学》2024年第22期12-16,共5页Contemporary Medicine

摘　　要：目的探讨不同通气模式在呼吸衰竭新生儿机械通气治疗中的价值。方法选取2020年1月至2022年1月抚州市第一人民医院收治的80例呼吸衰竭新生儿作为研究对象,采用随机数字表法分为A组与B组,各40例。A组实施同步间歇指令机械通气治疗,B组实施无创高频振荡通气治疗,比较两组临床疗效、康复时间指标、呼吸动力学指标、动脉血气指标、新生儿行为神经测定(neonatal behavioral neurological assessment,NABA)评分及并发症发生情况。结果B组治疗总有效率为95.00%,高于A组的80.00%,差异有统计学意义(P<0.05)。B组机械通气时间、开始经口喂养时间、氧气支持时间、住院时间均短于A组,差异有统计学意义(P<0.05)。治疗12、24、48、72 h,B组呼吸指数(respiratory index,RI)、氧合指数(oxygenation index,OI)均低于A组,差异有统计学意义(P<0.05)。治疗12、24、48、72 h,B组动脉血氧分压(partial pressure of arterial oxygen,PaO_(2))、pH值均高于A组,动脉血二氧化碳分压(partial pressure of carbon dioxide in arterial blood,PaCO_(2))低于A组,差异有统计学意义(P<0.05)。出生后3、7、14 d时,B组NABA评分均高于A组,差异有统计学意义(P<0.05)。B组并发症发生率为10.00%,低于A组的30.00%,差异有统计学意义(P<0.05)。结论与同步间歇指令机械通气治疗相比,对呼吸衰竭新生儿实施无创高频振荡通气治疗,可提升临床疗效,缩短患儿康复时间,改善呼吸动力学及血气指标,促进行为神经发育,降低并发症发生率,值得临床推广应用。Objective To explore the value of different ventilation modes in mechanical ventilation treatment of neonates with respiratory failure.Methods 80 neonates with respiratory failure admitted to First People's Hospital of Fuzhou from January 2020 to January 2022 were selected as the research subjects,they were divided into the group A and the group B according to the random number table method,with 40 cases in each group.The Group A received synchronous intermittent instruction mechanical ventilation treatment,while the group B received non-invasive highfrequency oscillatory ventilation treatment,the clinical efficacy,rehabilitation time indicators,respiratory dynamics indicators,arterial blood gas indicators,neonatal behavioral neurological assessment(NABA)scores and incidence of complications were compared between the two groups.Results The total effective rate in the group B was 95.00%,which was higher than 80.00%in the group A,and the difference was statistically significant(P<0.05).The mechanical ventilation time,the start time of oral feeding,the oxygen support time and the hospitalization time in the group B were shorter than those in the group A,and the differences were statistically significant(P<0.05).At 12,24,48 and 72 h after treatment,the respiratory index(RI)and oxygenation index(OI)in the group B were lower than those in the group A,and the differences were statistically significant(P<0.05).At 12,24,48 and 72 h after treatment,the partial pressure of arterial oxygen(PaO_(2))and pH value in the group B were higher than those in the group A,and the partial pressure of carbon dioxide in arterial blood(PaCO_(2))in the group B was lower than that in the group A,the differences were statistically significant(P<0.05).At 3,7 and 14 d after birth,NABA scores in the group B were higher than those in the group A,and the differences were statistically significant(P<0.05).The incidence of complications in the group B was 10.00%,which was lower than 30.00%in the group A,and the difference was statistically signific

关 键 词：呼吸衰竭 无创高频振荡通气 同步间歇指令机械通气 

分 类 号：R47[医药卫生—护理学]