同步间歇指令通气对呼吸衰竭新生儿血气指标的影响

摘要

Objective To investigate the effect of synchronized intermittent mandatory ventilation (SIMV) on blood gas indexes in neonates with respiratory failure.Methods From June 2015 to June 2017,in NICU of Shaoxing Central Hospital,116 neonates with respiratory failure were selected,according to the choice of ventilation mode,they were divided into SIMV group (60 cases,given SIMV ventilation) and continuous positive airway pressure (CPAP) group (56 cases,given CPAP).The clinical curative effect,blood gas indexes (PaCO2,PaO2,SpO2,OI) 3 d after treatment,the proportion of intubation and ventilator setting,duration of ventilation,hospital stay and incidence of complications in the two groups were compared.Results The effective rate in SIMV group was 93.33％,that in CPAP group was 80.36％,the difference was not statistically significant (P ＞ 0.05).3 d after treatment,the PaCO2 in SIMV group [(36.21±4.38) mmHg]was significantly lower than that in CPAP group [(42.54±5.19) mmHg],the difference was statistically significant (P ＜0.05),while the PaO2,SpO2 and OI [(63.29±5.19) mmHg,(0.95±0.08),(239.54±36.41)] were significantly higher than those in CPAP group [(57.19±5.09) mmHg,(0.91 ±0.09),(222.96 ±32.48)],the differences were statistically significant (P ＜ 0.05).The duration of ventilation,hospital stay,the proportion of intubation and ventilator setting,the total inci dence of complications in SIMV group [(34.12±10.78) h,(15.13±4.29),8.33％,20.00％] were compared with CPAP group [(48.75±12.49) h,(18.64±5.31) d,25.00％,44.64％],the differences were statistically significant (P ＜ 0.05).Conclusion The curative effect of SIMV is obvious in neonates with respiratory failure.It can improve blood gas indexes,shorten the duration of ventilation and reduce intubation and complications.%目的 探讨同步间歇指令通气(SIMV)对呼吸衰竭新生儿血气指标的影响.方法 选择2015年6月～2017年6月绍兴市中心医院新生儿重症监护室(NICU)收治的116例呼吸衰竭新生儿,根据选择通气模式不同,分为SIMV组(60例,采用SIMV通气)和持续气道正压通气(CPAP)组(56例,采用CPAP).比较两组临床疗效、治疗3d血气分析指标[动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、脉搏血氧饱和度(SpO2)、氧化指数(OI)]、插管上机比例、呼吸机通气时间、住院时间及并发症发生情况.结果 SIMV组有效率为93.33％,CPAP有效率为80.36％,两组比较差异有统计学意义(P＜0.05).治疗3d后,SIMV组PaCO2[(36.21±4.38)mmHg]明显低于CPAP组[(42.54±5.19)mmHg],差异有统计学意义(P＜ 0.05);SIMV组PaO2、SpO2、OI[(63.29±5.19)mmHg、(0.95±0.08)、(239.54±36.41)]明显高于CPAP组的[(57.19±5.09)mmHg、(0.91±0.09)、(222.96±32.48)],差异有统计学意义(P＜0.05).SIMV组呼吸机通气时间、住院时间、插管上机比例、总并发症发生率[(34.12±10.78)h、(15.13±4.29)、8.33％、20.00％]与CPAP组[(48.75±12.49)h、(18.64±5.31)d、25.00％、44.64％]比较,差异有统计学意义(P＜0.05).结论 呼吸衰竭新生儿采用SIMV的模式机械通气疗效显著,能够改善患儿血气指标,缩短机械通气时间,减少插管上机及并发症发生.