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目的探讨俯卧位通气联合肺复张治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法选取2014年1月-2016年1月在该院接受治疗的72例NRDS患儿为研究对象,随机分为对照组和研究组,每组各36例。对照组采用常规机械通气治疗,研究组在俯卧位通气基础上进行压力控制法肺复张治疗,监测并记录两组患儿治疗前后呼吸参数指标和血流动力学指标,记录两组患儿机械通气时间、吸氧时间和住院时间,比较两组患儿并发症的发生情况和预后情况。结果研究组患儿治疗1h、6h和12h后,二氧化碳分压(PaCO_2)和吸入氧浓度分数(FiO_2)均显著低于对照组(P<0.05),血氧分压(PaO_2)和血氧分压与吸入氧浓度比(PaO_2/FiO_2)均显著高于对照组(P<0.05);两组患儿治疗1h、6h和12h后的心律(HR)、中心静脉压(CVP)和平均动脉压(MAP)比较,差异无统计学意义(P>0.05);研究组患儿的机械通气时间、吸氧时间和住院时间分别为(4.53±0.84)d、(13.24±2.04)d和(24.18±5.68)d,均显著低于对照组的(6.18±0.92)d、(18.63±2.16)d和(29.74±3.96)d,两组比较差异有统计学意义(P<0.05);对照组患儿并发症发生率为13.89%,研究组患儿并发症发生率为8.33%,两组患儿并发症发生率比较差异无统计学意义(P>0.05)。治疗过程中,对照组患儿死亡4例,研究组患儿死亡1例。结论俯卧位通气联合压力控制法肺复张治疗NRDS可有效改善患儿的氧合功能,缩短机械通气时间,且不增加并发症的发生率,安全有效。
Objective To investigate the clinical effect of prone position ventilation combined with pulmonary reperfusion on neonatal respiratory distress syndrome (NRDS). Methods A total of 72 NRDS children treated in our hospital from January 2014 to January 2016 were randomly divided into control group and study group, 36 cases in each group. The control group was treated with routine mechanical ventilation. The study group was treated with pressure-controlled pulmonary re-ligation on the basis of prone position ventilation. The parameters of respiratory parameters and hemodynamics before and after treatment were monitored and recorded. Two groups of children with mechanical Ventilation time, oxygen inhalation time and hospital stay, comparisons of the incidence of complications and prognosis in both groups. Results After treatment for 1h, 6h and 12h, the PaCO_2 and FiO_2 in the study group were significantly lower than those in the control group (P <0.05) (PaO2 / FiO2) were significantly higher than those of the control group (P <0.05). The heart rate (HR), central venous pressure (CVP) and mean arterial pressure (P <0.05). The mechanical ventilation time, oxygen inhalation time and hospital stay in study group were (4.53 ± 0.84) d, (13.24 ± 2.04) d and (24.18 ± 5.68) d, were significantly lower than the control group (6.18 ± 0.92) d, (18.63 ± 2.16) d and (29.74 ± 3.96) d, the difference between the two groups was statistically significant (P <0.05) The complication rate was 13.89%. The complication rate in the study group was 8.33%. There was no significant difference in the complication rates between the two groups (P> 0.05). During treatment, 4 children died in the control group and 1 patient died in the study group. Conclusions Prostate ventilation combined with pressure control regimen of NRDS can effectively improve the oxygenation function of children and shorten the duration of mechanical ventilation without increasing the incidence of complications and is safe and effective.