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目的:探究目标容量通气(TTV)在新生儿呼吸窘迫综合征(NRDS)中的应用效果和并发症。方法:选取2011年12月~2014年6月该院收治的NRDS患儿70例,随机分成TTV组和对照组,每组各35例。TTV组采用目标容量通气加同步歇些通气联合压力支持通气(TTV+SIMV+PSV)模式通气治疗NRDS,对照组采用间歇通气联合辅助/控制(A/C)模式通气治疗NRDS,对比两组患儿的疗效和不良反应。结果:与治疗前相比,TTV组患儿治疗后6 h、1天、2天肺泡/动脉血氧分压、动脉血氧分压/吸入氧体积分数明显升高,对照组患儿治疗后1天、2天肺泡/动脉血氧分压、动脉血氧分压/吸入氧体积分数明显升高,差异有统计学意义(P<0.05)。与对照组相比,TTV组患儿治疗后6 h、1天、2天肺泡/动脉血氧分压、动脉血氧分压/吸入氧体积分数明显升高(P<0.01)。TTV组患儿呼吸机相关肺炎、气漏发生率均低于对照组,差异有统计学意义(χ2=4.158,P=0.041;χ2=4.200,P=0.040)。结论:TTV+SIMV+PSV治疗NRDS疗效优于传统的间歇通气联合A/C治疗,减少呼吸机相关肺炎等通气导致的并发症的发生。
Objective: To investigate the effect and complications of target volume ventilation (TTV) in neonatal respiratory distress syndrome (NRDS). Methods: Seventy children with NRDS admitted to our hospital from December 2011 to June 2014 were randomly divided into TTV group and control group, with 35 cases in each group. In TTV group, NRDS was treated with TAC + SIMV + PSV ventilation, while control group was treated with intermittent ventilation combined with A / C ventilation. NRDS was compared between the two groups Children’s efficacy and adverse reactions. Results: Compared with before treatment, the alveolar / arterial partial pressure of oxygen and arterial partial pressure of oxygen / inhaled oxygen in 6 hours, 1 day and 2 days after treatment in TTV group were significantly increased, while in control group, The alveolar / arterial oxygen pressure, arterial oxygen pressure / inspired oxygen volume fraction increased significantly on day 1 and day 2, with statistical significance (P <0.05). Compared with the control group, the alveolar / arterial partial pressure of oxygen, arterial partial pressure of oxygen and inhaled oxygen in 6 hours, 1 day and 2 days after treatment in TTV group were significantly increased (P <0.01). The incidence of ventilator-associated pneumonia and air leak in children with TTV were significantly lower than those in the control group (χ2 = 4.158, P = 0.041; χ2 = 4.200, P = 0.040). Conclusion: The treatment of NRDS by TTV + SIMV + PSV is superior to the traditional intermittent ventilation combined with A / C treatment, and can reduce the complications caused by ventilator-associated pneumonia.