同步间歇指令通气联合容量保证通气模式治疗新生儿呼吸窘迫综合征临床研究.docVIP

同步间歇指令通气联合容量保证通气模式治疗新生儿呼吸窘迫综合征临床研究 　　【摘要】 目的：比较同步间歇指令通气联合容量保证通气（SIMV+VG）与同步间歇指令通气（SIMV）治疗新生儿呼吸窘迫综合征（NRDS）的治疗效果。方法：选取2016年1月-2017年4月本院收治的NRDS早产儿77例，按照入院先后顺序将其分为SIMV+VG组（n=39）和SIMV组（n=38），两组均应用肺表面活性物质（PS），均采用婴儿呼吸机通气治疗，SIMV+VG组采用SIMV+VG模式，SIMV组采用SIMV模式。比较两组应用PS前、应用PS后1 h、通气12 h的平均气道压，比较两组有创通气持续时间。结果：应用PS前，两组平均气道压比较，差异无统计学意义（P0.05）；应用PS后 　　1 h、通??12 h，两组平均气道压均逐渐下降，且SIMV+VG组均低于SIMV组，比较差异均有统计学意义（P0.01）；SIMV+VG组有创通气持续时间为46.75（35.63，64.17）h，短于SIMV组的65.57（43.85，113.24）h，比较差异有统计学意义（Z=-2.313，P=0.021）。结论：在NRDS的治疗中，SIMV+VG模式与SIMV模式相比较，能缩短有创通气时间，更有效地降低平均气道压，更为安全有效，值得临床推广。 　　【关键词】 同步间歇指令通气； 容量保证； 新生儿呼吸窘迫综合征 　　【Abstract】 Objective：To compared the effects of synchronized intermittent mandatory ventilation combined with volume guarantee（SIMV+VG） and synchronized intermittent mandatory ventilation（SIMV） in treatment of neonatal respiratory distress syndrome（NRDS）.Method：A total of 77 cases of premature infants with NRDS admitted in our hospital from January 2016 to April 2017 were selected.According to the order of admission，they were divided into SIMV+VG group（n=39） and SIMV group（n=38）.They were treated with pulmonary surfactant（PS），and all of them were treated with ventilatory ventilation in infants，the SIMV+VG group received SIMV+VG model，and SIMV group received SIMV model.The average airway pressure was compared between two groups before PS，1 h after PS and 12 h of ventilation，and the duration of invasive ventilation in two groups was compared.Result：Before PS，the average airway pressure in two groups was compared，the difference was not statistically significant（P0.05）；1 h after PS and 12 h of ventilation，the average airway pressure in two groups decreased gradually，and the SIMV+VG group were all lower than those of SIMV group，the differences were statistically significant（P0.01）.The duration of invasive ventilation in SIMV+VG group was 46.75（35.63，64.17）h ，which was shorter than 65.57（43.85，113.24）h of SIMV group，the difference was statistically significant（Z=-2.313，P=0.021