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目的 探讨足月新生儿急性呼吸窘迫综合征 (ARDS)的治疗及预后。方法 回顾分析 1999年 1月至2 0 0 2年 3月收治的 10例足月新生儿ARDS机械通气的时机、时间及呼吸机参数的调节和并发症。结果 10例患儿中 7例治愈 ,1例好转 ,2例死亡。开始用呼吸机时间最短于发病后 2h ,最长于发病后 48h ,平均 (17 0±13 9)h ,平均机械通气时间 (68 1± 2 3 9)h。呼吸机参数最高值吸气峰压 (PIP) (2 45± 0 3 5 )kPa[(2 5 0 0±3 5 6)cmH2 O] ,平均气道压 (MAP) (1 0 8± 0 2 6)kPa[(11 0 5± 2 69)cmH2 O] ,FiO2 0 67± 0 15 ,最高PIP持续时间 (2 8 3± 5 8)h ,最高FiO2 持续时间 (9 1± 8 9)h。合并气胸 1例 ,呼吸机相关性肺炎 (VAP) 4例 ,缺氧缺血性脑病 4例 ,多脏器损害 3例。结论 ARDS患儿早期诊断 ,早期机械通气治疗 ,应用较低的呼吸机参数 ,可避免缺氧引起的多脏器功能损害及呼吸机相关性肺损伤 ,提高治愈率
Objective To investigate the treatment and prognosis of full-term neonatal acute respiratory distress syndrome (ARDS). Methods A retrospective analysis was performed on the timing and timing of mechanical ventilation and the ventilator parameters in 10 full-term newborns admitted to our hospital from January 1999 to March 2002. Results Of the 10 children, 7 were cured, 1 improved and 2 died. The time to start using ventilator was the shortest after 2 hours, the longest time was 48 hours after onset, with an average of (17 0 ± 13 9) h and mean mechanical ventilation time (68 1 ± 23 9) h. The maximum ventilatory parameters peak inspiratory peak pressure (PIP) (2 45 ± 0 3 5) kPa [(25 00 ± 35 56) cmH 2 O], mean airway pressure (MAP 1 0 8 ± 0 2 6) kPa [(11 05 ± 2 69) cmH 2 O], FiO2 0 67 ± 0 15, maximum PIP duration (2 8 3 ± 5 8) h and maximum FiO2 duration (9 1 ± 8 9) h. 1 case of pneumothorax, ventilator-associated pneumonia (VAP) in 4 cases, 4 cases of hypoxic-ischemic encephalopathy, multiple organ damage in 3 cases. Conclusion Early diagnosis and early mechanical ventilation in children with ARDS can avoid hypoxia induced multiple organ dysfunction and ventilator-associated lung injury and improve the cure rate