摘要
目的 探讨肺表面活性物质 (plumonarysurfactant,PS)对新生儿肺透明膜病 (hyalinemembranediseaseofnewborn ,HMD)呼吸力学影响。方法 对 2 9例HMD患儿行常规频律机械通气治疗时进行呼吸力学监测。其中 18例给予PS治疗 (PS组 ) ,另 11例未使用PS (NPS组 ) ,比较两组患儿呼吸力学监测结果。结果 治疗后 6h时 ,PS组静态肺顺应性 (Cstat)、吸气峰流量 (InspFlow)明显增加 (P <0 0 0 1) ,而NPS组尚无明显改变 (P >0 0 5 ) ;此后两组以上指标随时间延长增长 ,治疗后 72h较治疗前均明显增加 (P<0 0 0 1) ;但各时段组间比较 ,PS组明显高于NPS组 (P <0 0 1)。两组压力 -容积环 (P -Vloop)钭率随时间延长逐渐增大 ,PS组更接近纵座标。治疗后 6hPS组Rinsp明显降低 (P <0 0 0 1) ,而NPS组无明显变化 (P >0 0 5 ) ;治疗后 72h ,两组较治疗前明显降低 (P <0 0 0 1) ;但相应时段组间比较 ,PS组明显低于NPS组 (P <0 0 1)。治疗前后呼气时间常数 (RCexp)无显著差异 (P >0 0 5 )。治疗后 72hPS组自主呼吸功 (WOBimp)明显低于NPS组 (P <0 0 5 )。结论 HMD患儿机械通气加用PS ,肺顺应性、通气流量明显增加 ;气道阻力明显降低 ;患儿自主呼吸功耗相对较少 ,效果优于单用机械通气。
Abstract Objective To study the respiratory mechanics influence of pulmonary surfactant (PS) on hyaline membrane disease of newborn (HMD).Methods We monitored the respiratory mechanics of 29 newborn infants, diagnosed as hyaline membrane disease of newborn (HMD) and needed ventilator support in NICU.18 newborns received given PS treatment (PS group), another 11 patients were not given by PS (NPS group), to and of respiratory mechanics in two groups were compared. Results 6 hr after treatment, the Cstat (Static compliance) and Insp Flow (Inspiratory peak flow) were obviously increased (both P<0.001) while that of NPS group has no obvious change (P>0.05);72 hr after treatment,two groups increased obviously compard with before treatment before (P<0.001); PS group are higher than NPS group on each period time (P<0.01).The slope of Pressure-Volume loop (P-V loop)of two groups gradually increased with treatment time.The RCexp (Expiratory time constant) showed no obvious difference in before and after treatment (P>0.05)(6～48 h),72 hr after treatment the WOBimp (Imposed work of breathing) in PS group obviously lower than NPS group(P<0.05).Conclusion addition of PS in HMD infants with ventilation is more effective than ventilation alone. Their lung compliance and flow rate increased obviously, airway resistance decreased obviously and work of breathing was relatively.
出处
《中华急诊医学杂志》
CAS
CSCD
2004年第6期370-372,共3页
Chinese Journal of Emergency Medicine
关键词
肺表面活性物质
新生儿
肺透明膜病
呼吸力学
机械通气
Pulmonary surfactants
Hyaline membrane disease of newborn
Ics
mechanicals Ventilation
