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目的:观察同步间歇指令通气(SIMV)治疗新生儿呼吸窘迫综合征(NRDS)的疗效。方法:25例NRDS患儿采用SIMV模式进行治疗,观察其治疗前后动脉血气、PaO2/PAO2、PaO2/FiO2指标变化及临床疗效。结果:治疗后2h内患儿临床症状明显改善,皮肤紫绀消失,吸气性三凹征明显减轻或消失,外周循环改善;治疗后动脉血气pH、PaO2、SaO2值逐渐上升,PaCO2、BE负值逐渐下降,治疗后8h的pH、PaCO2、BE负值与治疗前相比差异有统计学意义(P<0.01),2h、8h的PaO2、SaO2与治疗前相比差异有统计学意义(P<0.01),治疗后2h、8h的PaO2/PAO2、PaO2/FiO2值高于治疗前,所需氧浓度低于治疗前,与治疗前比较差异均有统计学意义(P<0.01);25例患儿中19例存活,3例死亡,3例放弃治疗,治愈率76%,无1例出现气漏、肺出血等机械通气相关性肺损伤。结论:SIMV模式治疗NRDS能有效改善肺换气和通气功能,具有良好疗效。
Objective: To observe the effect of SIMV on neonatal respiratory distress syndrome (NRDS). Methods: Twenty - five children with NRDS were treated with SIMV. The changes of arterial blood gas, PaO 2 / PAO 2, PaO 2 / FiO 2 and their clinical effects were observed before and after treatment. Results: After 2 hours of treatment, the clinical symptoms of children were significantly improved, the cyanosis of the skin disappeared, the aspiration signs of three concave were significantly reduced or disappeared, and the peripheral circulation improved. After treatment, the values of arterial blood gas pH, PaO2 and SaO2 gradually increased, PaCO2 and BE negative (P <0.01). PaO2 and SaO2 at 2h and 8h were significantly different from those before treatment (P <0.01), and the differences were statistically significant (P < 0.01). The values of PaO2 / PAO2 and PaO2 / FiO2 at 2 h and 8 h after treatment were higher than those before treatment, the required oxygen concentration was lower than before treatment, and the difference was statistically significant (P <0.01) 19 cases of children survived, 3 died, 3 gave up treatment, the cure rate was 76%, no one case of air leaks, pulmonary hemorrhage and other mechanical ventilation-related lung injury. Conclusion: SIMV mode of treatment of NRDS can effectively improve pulmonary ventilation and ventilation, with good curative effect.