比例辅助通气联合SIMV通气模式在新生儿呼吸窘迫综合征中的临床疗效观察

摘要

Objective To explore the clinical efficacy of proportional assist ventilation combined with synchronized intermittent mandatory ventilation in neonatal respiratory distress syndrome.Methods 66 cases of neonatal respiratory distress syndrome were retrospectively analyzed.According to different invasive ventilation mode, they were divided into the control group given synchronized intermittent mandatory ventilation mode (SIMV) and the observation group given proportional assist ventilation (PAV) combined with SIMV ventilation mode.Their carbon dioxide partial pressure (PaCO2), oxygenation index (PaO2/FiO2), changes of mean airway pressure as well as the number of man-machine confrontation were compared between the two groups.Results The PaCO2 level at 6h, 12h, 24h, and 48 hours after treatment decreased more significantly in the observation group than in the control group (P<0.05).The oxygenation index (PaO2/FiO2) at 1h, 6h, 12h, 24h and 48h after treatment showed no significant difference between the two groups (P>0.05).The mean airway pressure and the number of man-machine confrontation at 1h, 6h, 12h, 24h and 48h after treatment decreased more significantly in the observation group than in the control group (P<0.05).Conclusion Proportional assist ventilation combined with SIMV has low mean airway pressure and PaCO2 level for treatment of neonatal respiratory distress syndrome, while maintaining the same oxygenation index.%目的 探讨比例辅助通气联合SIMV通气模式在新生儿呼吸窘迫综合征中的临床疗效.方法 回顾性分析呼吸窘迫综合征的新生儿66例,按照有创通气模式的不同,分为同步间歇指令通气模式(SIMV)模式(对照组)以及比例辅助通气模式(PAV)联合SIMV通气模式(观察组).观察并比较两组患儿在不同有创通气模式后的二氧化碳分压(PaCO2),氧合指数(PaO2/FiO2),平均气道压力的变化以及人机对抗次数.结果 观察组PaCO2水平在治疗后6h、12h、24h以及48小时时均较同时期对照组的PaCO2水平显著降低(P<0.05).观察组氧合指数(PaO2/FiO2)在治疗后1h、6h、12h、24h以及48与对照组比较,无统计学差异(P>0.05).观察组平均气道压力以及人机对抗次数在治疗后1h、6h、12h、24h以及48h与对照组比较,降低更为显著(P<0.05).结论 比例辅助通气联合SIMV通气模式治疗呼吸窘迫综合征新生儿,在维持同样的氧合指数情形下,具有低平均气道压及PaCO2水平,具有临床推广较好的应用价值.