气道压力释放通气对早产儿ARDS动态氧合状态及预后的影响  

Effect Research of Airway Pressure Release Ventilation on Dynamic Oxygenation Status and Prognosis of Premature Infants with ARDS

作　　者：叶效昌 赵智东 裴敏昕 YE Xiaochang;ZHAO Zhidong;PEI Minxin(Department of Pediatrics,Dongguan Dalang Hospital,Dongguan,Guangdong 523000)

机构地区：[1]广东东莞市大朗医院儿科,广东东莞523000

出　　处：《智慧健康》2024年第34期33-35,共3页Smart Healthcare

基　　金：东莞市社会发展科技项目《气道压力释放通气和同步间歇强制通气对早产儿ARDS患者肺损伤程度的比较研究》(项目编号:20231800938202)。

摘　　要：目的研究气道压力释放通气对早产儿急性呼吸窘迫综合征(ARDS)动态氧合状态及预后的影响。方法回顾性分析2021年5月—2023年12月于本院就诊的70例ARDS早产儿的临床资料,按照治疗方法的不同将其分为研究组(n=38)和对照组(n=32)。研究组采用气道压力释放通气法进行治疗,对照组采用同步间歇强制通气法进行治疗,比较两组所设置的呼吸机的参数(潮气量、气道压力、呼吸频率)、治疗前及治疗后氧合指标[动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、酸碱度(pH)、血乳酸(Lac)]、不良事件(气管脱落、低氧血症、二氧化碳潴留)发生率。结果研究组潮气量与对照组相比,差异无显著统计学意义(P>0.05);研究组气道压力和呼吸频率均低于对照组(P<0.05);通气后,研究组PaO_(2)显著高于对照组(P<0.05),研究组PaCO_(2)显著低于对照组(P<0.05),但两组pH和Lac比较,差异均无统计学意义(P>0.05);研究组不良事件总发生率显著低于对照组(P<0.05)。结论气道压力释放通气能更有效地改善早产儿ARDS的动态氧合状况,降低其不良事件总发生率,更有利于早产儿后期的肺部发育。Objective To investigate the effect of airway pressure release ventilation on dynamic oxygenation status and prognosis of premature infants with acute respiratory distress syndrome(ARDS).Methods The paper reviewed and analyzed 70 premature infants with ARDS in our hospital from May 2021 to December 2023,and divided them into the study group(n=38)and the control group(n=32)according to different treatment methods.The study group was treated with airway pressure release ventilation,and the control group with synchronous intermittent forced ventilation.Parameters(tidal volume,airway pressure,respiratory rate)of ventilators were compared between two groups.Oxygenation indexes of arterial partial oxygen pressure(PaO_(2)),arterial partial carbon dioxide pressure(PaCO_(2)),pH and blood lactate(Lac)were compared before and after treatment.Incidence of adverse events(trachea abscission,hypoxemia and carbon dioxide retention)were compared between two groups.Results There was no significant statistical difference in tidal volume between the study group and the control group(P>0.05).Airway pressure and respiratory rate of the study group was lower than the control group,difference was statistically significant(P<0.05).After ventilation,the PaO_(2) of the study group was significantly higher than the control group,difference was statistically significant(P<0.05).The PaCO_(2) of the study group was significantly lower than the control group,there was no significant statistical difference in pH and Lac between two groups(P>0.05).Total incidence of adverse events in the study group was significantly lower than the control group,difference was statistically significant(P<0.05).Conclusion Airway pressure release ventilation can improve dynamic oxygenation status of premature infants with ARDS effectively,with low overall incidence of adverse events,which is conducive to lungs development of premature infants in future.

关 键 词：气道压力释放通气 同步间歇强制通气 动态氧合状态 早产儿 急性呼吸窘迫综合征 

分 类 号：R72[医药卫生—儿科]