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早产儿常因呼吸性酸中毒、呼吸窘迫综合征引起的低氧血症和围产期窒息需要气管内插管进行治疗。但插管时的生理变化常被忽视。作者选择10例呼吸衰竭需要气管内插管治疗的早产儿,6例为呼吸窘迫综合征,4例多次严重窒息合并心动过缓和低氧血症。呼吸窘迫综合征的患儿都伴有呼吸性酸中毒(pH<7.25,PaCO_2>45托)。此10例患儿体重平均1.19kg,出生平均8天(10小时～30天),胎儿期平均29.4周(26～37周)。插管前,先用纯氧经面罩换气数次。置入喉镜后,收缩压即由基础值65±20增至84±24mmHg(P<0.001),插入导管后增至95±36mmHg(P<0.01)。心率由基础值154±19降至112±38次/min(P<0.01),经皮氧分压(PtcO_2)由基础值83±14降至49±28托(P<0.01),脉压比基础值平均增加13±9mmHg(P<0.01)。7例患儿在置喉镜、吸引口咽分泌物时收缩压平均增高11±20mmHg,但无统计学意义。5例患儿在用纯氧
Premature babies often require endotracheal intubation due to respiratory acidosis, respiratory distress syndrome caused by hypoxemia and perinatal asphyxia. However, the physical changes during intubation are often overlooked. The authors selected 10 cases of respiratory failure requiring endotracheal intubation treatment of premature children, 6 cases of respiratory distress syndrome, 4 cases of multiple severe asphyxia with bradycardia and hypoxemia. Respiratory distress syndrome is associated with respiratory acidosis (pH <7.25, PaCO_2> 45 Torr). The average weight of these 10 infants was 1.19 kg and their average birth was 8 days (10 hours to 30 days). The mean age of fetuses was 29.4 weeks (26-37 weeks). Before intubation, first with pure oxygen through the mask ventilation several times. After laryngoscopy, the systolic pressure was increased from baseline (65 ± 20) to 84 ± 24 mmHg (P <0.001) and increased to 95 ± 36 mmHg after catheterization (P <0.01). Heart rate decreased from baseline value of 154 ± 19 to 112 ± 38 breaths per minute (P <0.01), transcutaneous oxygen pressure (PtcO_2) decreased from baseline value of 83 ± 14 to 49 ± 28 torr (P <0.01) The basal value increased by an average of 13 ± 9 mmHg (P <0.01). 7 cases of children with laryngoscopy, oropharyngeal secretions attract systolic blood pressure increased 11 ± 20mmHg, but no statistically significant. Five patients were treated with pure oxygen