论文部分内容阅读
目的:探讨允许性高碳酸血症通气治疗西宁地区新生儿呼吸衰竭的优越性及临床应用价值。方法:46例呼吸衰竭患儿应用高碳酸血症通气治疗,与我科曾统计的64例常规机械通气治疗比较,两组通气方式均为IPPV+PEEP,呼吸机条件初设值相同,治疗组采用PHV法通气,降低吸气分压及吸气末正压,允许PaCO2在45mmHg～50mmHg之间,对照组采用常规通气方式,以较高通气条件维持血气PaCO2在(35～45)mmHg,比较两组患儿治疗过程中血气平均值,比较两组患儿平均上机时间、治愈率、死亡率及并发症的多少。结果:两组患儿治疗过程中血气平均值比较PHV组PCO2高于对照组,PaO2/FiO2、PaO2两组无差异,pH值在PHV组较对照组低,对照组气漏发生2例,发生率3.12%,死亡6例,病死率9.36%,PHV组无气漏发生,死亡4例,病死率8.67%,治愈率从78.12%提高至80.43%,平均上机时间缩短。结论:应用允许性高碳酸血症通气法,能有利于尽早恢复正常呼吸功能,缩短机械通气时间,提高治愈率,减少并发症的发生。
Objective: To investigate the superiority and clinical value of permissive hypercapnic ventilation in the treatment of neonatal respiratory failure in Xining area. Methods: 46 cases of respiratory failure in children with hypercapnia ventilation treatment, and our department had statistics of 64 cases of conventional mechanical ventilation, the two groups of ventilation were IPPV + PEEP, ventilator conditions initial set the same value, the treatment group PHV ventilation was used to reduce the inspiratory partial pressure and positive end-inspiratory pressure, allowing PaCO2 between 45mmHg ~ 50mmHg. The control group was ventilated with conventional ventilation to maintain PaCO2 (35 ~ 45) mmHg with high ventilation Two groups of children in the treatment of blood gas during the average, compared the average two sets of children on the machine time, cure rate, mortality and complications how much. Results: The average blood gas in PHV group was higher than that in control group in PaO2 / FiO2 and PaO2 groups. There was no difference in PaO2 / FiO2 and PaO2 between the two groups. PH value was lower in PHV group than in control group. Gas leakage in control group occurred in 2 cases The death rate was 3.12%, the death rate was 6%, and the mortality rate was 9.36%. There was no air leakage in PHV group. There were 4 deaths and the case fatality rate was 8.67%. The cure rate increased from 78.12% to 80.43%. Conclusion: Permissive hypercapnia ventilation method can be used to restore normal respiratory function as soon as possible, shorten the time of mechanical ventilation, improve the cure rate and reduce the incidence of complications.