摘要
目的 探讨允许性高碳酸血症通气法(PHV)在治疗新生儿呼吸窘迫综合征(NRDS)中的价值。方法 随机选择两组需机械通气治疗的NRDS病人,对照组(n=25)以传统通气方式治疗,PHV组(n=31)降低PIP、PEEP、MAP等通气条件,允许血气中PaCO_2超过正常值,在45～55mmHg之间,比较两组通气条件、通气过程中血气值及并发症、病死率。结果 两组在通气过程中,PaCO_2/FiO_2及PaCO_2无显著性差异(P均>0.05),而pH值、PaCO_2有显著性差异(P<0.05和P<0.01),同时PHV组上机时间显著减少(P<0.05),气漏发生率和病人死亡率均降低(0/12％和12.9％/24％)。结论 PHV法在治疗NRDS中较传统通气方式能降低并发症的发生率及病死率,具有推广价值。
To search the value of permissive hypercapnia ventilation (PHV) in the treatment of
neonatal respiratory distress syndrome(NRDS). Methods All patients with NRDS were randomly divid-
ed into two group, who need mechanical ventilation. The patients in control group were received tradition
ventilation manner treatment. In PHV group, PaCO_2 was maintained between 45 mmHg and 55 mmHg by
reducing the parameters of peak inspiratory pressure(PIP) and positive end-expiratory pressure(PEEP)
and mean airway pressure(MAP). Finally the parameters of ventilation and arterial blood gas and compli-
cation during the ventilation and fatality rate were analysed in two groups. Results There was no signifi-
cat difference in the parameters of PaO_2/FiO_2 and PaO_2 between the control and PHV groups(P>0.05).
The value of pH and PCO_2 in two groups had significant difference(P<0.05 and P<0.01). Mean-
while, in PHV group, the time using mechanical ventilation was markedly shorted(P<0.05), and inci-
dence of air leak and fatality rate were significantly reduced(0/12% and 12.9%/24%). Conclusion
PHV stretagy in NRDS trerapy can significantly reduced the rate of complication and fatality rate.
出处
《新生儿科杂志》
2004年第3期97-99,143,共4页
The Journal of Neonatology
