摘要
目的探讨患者触发通气(PTV)辅助/控制(A/C)模式治疗新生儿呼吸衰竭的临床疗效。方法对新生儿重症监护病房(NICU)应用PTVA/C通气模式治疗的59例呼吸衰竭新生儿临床资料进行回顾性分析,探讨患儿呼吸机治疗后的临床表现、动脉血气变化、并发症的防治及撤机方法。结果59例呼吸衰竭新生儿应用PTVA/C通气模式治疗后30min内,紫绀消失或明显改善48例(81%);呼吸困难减轻44例(75%);1h后血气分析PaO2由(5.63±1.82)kPa升高到(11.43±3.14)kPa,PaCO2由(6.83±1.48)kPa下降到(5.03±1.22)kPa,SaO2由(67.16±9.80)%升高到(94.25±4.93)%,3组数据前后对比在统计学上差异均有显著性(P<0.01)。在59例患儿中,存活45例,存活率76%;死亡11例,病死率19%;自动出院3例。有32例患儿发生并发症(43例次),其中呼吸机相关性肺炎(VAP)29例,肺不张4例,气漏和肺出血各3例,慢性肺部疾病(CLD)和颅内出血各2例。结论选用PTVA/C模式作为开始通气模式是治疗新生儿呼吸衰竭的较好选择。
Objective To study the clinical effects of patient-triggered ventilation assist/control(PTV A/C)support on respiratory failure in neonates. Methods Fifty-nine newborn infants diagnosed as respiratory failure, recruited from the neonatal intensive care unit(NICU) were analyzed. Neonates with respiratory failure were treated with PTV A/C ventilation support, and the clinical symptoms, artery blood gas analysis, prevention and treatment of the complications and the method of ventilator weaning were analyzed. Results Among the 59 neonates, disappeared or was significantly improved after 30 minutes of treatment in 48 patients(81.4%). Respiratory distress was improved in 44 patients(74.6%). One hour after ventilation support,PaO_2 increased from(5.63±1.82)kPa to(11.43±3.14)kPa,PaCO_2 decreased from(6.83±1.48)kPa to(5.03±1.22)kPa, SaO_2 increased from (67.16±9.80)% to (94.25±4.93)%. 45 cases(76.3%) survived, 11 cases died, 3 cases gave up treatment, 32 cases had complications including air leak(3 cases), chronic lung disease(2 cases), ventilator-associated pneumonia(VAP) (29 cases), intracranial hemorrhage(2 cases), pulmonary hemorrhage(3 cases), lung collapse(4 cases). Conclusion The PTV A/C ventilation support is a good choice for neonatal respiratory failure.
出处
《广东医学》
CAS
CSCD
北大核心
2005年第7期883-885,共3页
Guangdong Medical Journal
