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目的:探讨用自动充气式复苏囊(SIB)提供呼气末持续正压(PEEP)设备,手控高频持续正压通气在转运新生儿重型肺出血的临床方法和应用价值。方法:需转运新生儿重型肺出血36例,在气管插管解除气道梗阻、止血、纠酸、抗休克等对症支持治疗基础上,采用SIB+PEEP阀手控高频持续正压通气,观察患儿病情加重、并发症发生,监测并比较治疗前及治疗后不同通气时间的血气值。结果:100%转运成功,转运途中病情无恶化,无1例气漏、持续肺动脉高压,治疗前与治疗后各时间点血气PH、PaO2、PaCO2、PaO2/FiO2分别进行配对t检验,P<0.01,表明治疗后肺的通气、换气有明显改善;治愈30例(83.33%),合并多器官功能衰竭放弃后死亡6例(16.67%)。结论:手控高频持续正压通气转运新生儿重型肺出血方法可靠、有效、便于推广。
Objective: To explore the clinical methods and application value of continuous positive pressure expiratory pressure (PEEP) device by automatic inflatable resuscitation capsule (SIB) and manual high-frequency continuous positive pressure ventilation in transporting neonatal heavy pulmonary hemorrhage. Methods: Thirty-six cases of severe neonatal pulmonary hemorrhage were transplanted. On the basis of symptomatic and supportive therapy of tracheal intubation to relieve airway obstruction, hemostasis, acidosis and anti-shock, SIB + PEEP valve was used to control continuous positive pressure ventilation Children with exacerbations, complications, monitoring and comparison of blood values before and after treatment of different ventilation time. Results: 100% transepithelization was successful. There was no worsening of the disease during transit. There was no air leak in 1 case and persistent pulmonary hypertension. Paired t-test was performed on the blood PH, PaO2, PaCO2 and PaO2 / FiO2 respectively before and after treatment, P <0.01 , Which showed that lung ventilation and ventilation were improved obviously after treatment. Thirty patients (83.33%) were cured and 6 patients (16.67%) died after abandonment with multiple organ failure. Conclusion: Manual high-frequency continuous positive pressure ventilation is reliable, effective and easy to popularize for neonatal heavy pulmonary hemorrhage.