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3种模式机械通气治疗新生儿呼吸窘迫综合征的疗效 被引量:21

Three kinds of mechanical ventilations for treating neonatal respiratory distress syndrome
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摘要 目的比较比例辅助通气(PAV)、高频振荡通气(HFOV)、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。方法采用回顾性研究,对2008年5月至2012年5月在江门市中心医院使用过PAV、HFOV、SIMV3种机械通气模式之一治疗,且符合病例纳入标准的161例NRDS患儿的临床资料进行分析,按照使用呼吸机的通气模式不同分为3组,比较其疗效。结果PAV组采用PAV治疗43例,HFOV组采用HFOV治疗58例,SIMV组采用SIMV治疗60例,3组间性别、出生胎龄、出生体质量、使用固尔苏剂量比较差异均无统计学意义(P均〉0.05);PAV组、HFOV组、SIMV组治疗有效病例分别为37例、57例、52例,无效病例分别为6例、1例、8例,3组疗效比较差异有统计学意义(X^2=6.197,P=0.045),其中PAV组与SIMV组比较差异无统计学意义(X^2=0.008,P=0.928),HFOV组明显优于PAV组与SIMV组(X^2=3.986,P=0.046;X^2=4.114,P=0.043)。结论HFOV治疗NRDS的疗效较好,可以作为优先选择。 Objective To contrast the curative effects of proportional assist ventilation (PAV) and high frequency oscillatory ventilation(HFOV) and synchronized intermittent mandatory ventilation(SIMV) on treatment of neonatal respiratory distress syndrome (NRDS). Methods A retrospective study was carried out based on clinical data of 161 neonates. The research subjects were the neonates who had been hospitalized from May 2008 to May 2012 in Jiang- men Central Hospital and received one of the mechanical ventilation methods. The subjects were divided into 3 groups according to used mechanical ventilation mode they received, and their curative effect was compared. Results Forty- three cases in PAV group were treated by PAV,58 cases in HFOV group received HFOV ,and 60 cases in SIMV group received SIMV. In comparison with sex ratio, gestational age of birth,birth weight, dose of poractant alfa injection there was no differece among 3 groups ( all P 〉 0.05 ). The number of effective cases in PAV group, HFOV group and SIMV group was 37 cases, 57 cases,52 cases, respectively; the invalid cases including 6 cases, 1 case, 8 cases in 3 groups, re~ spectively. Among the 3 groups,the curative effect was significantly different(x2 =6. 197,P =0.045) ,curative effect of PAV group was not different from that of SIMV group(X^2 =0.008 ,P =0.928) ,curative effect of HFOV group was better than that of PAV group and SIMV group (X^2 = 3. 986, P = 0. 046 ;X^2 = 4.114, P = 0.043 ). Conclusion The curative effect of HFOV for neonatal respiratory distress syndrome was better,which could be recommended.
出处 《中华实用儿科临床杂志》 CAS CSCD 北大核心 2013年第2期124-126,共3页 Chinese Journal of Applied Clinical Pediatrics
基金 广东省医学科学基金资助课题(2008003)
关键词 比例辅助通气 高频振荡通气 同步间歇指令通气 呼吸窘迫综合征 婴儿 新生 Proportional assist ventilation High frequency oscillatory ventilation Synchronized intermittent mandatory ventilation Respiratory distress syndrome Infant, newborn
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参考文献13

  • 1(S)timac T,Petrovi(c) O,Krajina R. Lamellar body count as a diagnostic test in predicting neonatal respiratory distress syndrome[J].Croatian Medical Journal,2012,(03):234-238.
  • 2Singh N,Hawley KL,Viswanathan K. Efficacy of porcine versus bovine surfactants for preterm newborns with respiratory distress syndrome:systematic review and meta-analysis[J].Pediatrics,2011,(06):e1588-e1595.
  • 3Costa R,Spinazzola G,Cipriani F. A physiologic comparison of proportional assist ventilation with load-adjustable gain factors(PAV +)versus pressure support ventilation (PSV)[J].Intensive Care Medicine,2011,(09):1494-1500.
  • 4刘郴州,刘东,郭青云,关浩锋,黄碧茵,上官明.成比例辅助通气治疗早产儿呼吸窘迫综合征的疗效[J].实用儿科临床杂志,2010,25(2):121-122. 被引量:11
  • 5Rieger-Fackeldey E,Schaller-Bals S,Schulze A. Effect of body temperature on the pattern of spontaneous breathingin extremely low birth weightinfants supported by proportional assist ventilation[J].Pediatric Research,2003,(03):332-336.doi:10.1203/01.PDR.0000076664.65100.FF.
  • 6段江,何玺玉,郑天,孔祥永,封志纯.成比例辅助通气在呼吸机依赖极低出生体重儿中的临床应用[J].中国当代儿科杂志,2012,14(6):401-405. 被引量:3
  • 7Patel DS,Rafferty GF,Hannam S. In vitro assessment of proportional assist ventilation[J].Archives of Disease in Childhood:Fetal and Neonatal Edition,2010,(05):F331-F337.
  • 8李云,武荣.比例辅助通气在胎粪吸入综合征治疗中的应用[J].中国医疗前沿,2009,4(24):34-34. 被引量:14
  • 9Singh SN,Malik GK,Prashanth GP. High frequency oscillatory ventilation versus synchronized intermittent mandatory ventilation in preterm neonates with hyaline membrane disease:a randomized controlled trial[J].Indian Journal of Pediatrics,2012,(05):405-408.
  • 10付素珍.应用高频通气辅助治疗小儿重症肺炎疗效分析[J].新乡医学院学报,2011,28(4):450-451. 被引量:12

二级参考文献30

  • 1罗群,李缨,陈荣昌,郑则广,李寅环,秦朝辉.慢性阻塞性肺疾病急性发作期患者对比例辅助通气的生理反应[J].中华结核和呼吸杂志,2004,27(11):743-747. 被引量:11
  • 2吴国荣,许旺,赵丽玲,王建锋,祁春雷,朱静.成比例辅助机械通气治疗慢阻肺合并高碳酸血症的研究[J].宁夏医学杂志,2007,29(6):489-491. 被引量:3
  • 3Frantz C, Ploner Y, Groschel A, et al. Proportional assist ventilation: A modem ventilation technique [ J ]. Dtsch Med Wochenschr, 2007, 132 (10) :501 -503.
  • 4Sinderby C, Beck J. Proportional assist ventilation and neuraUy adjusted ventilatory assist - - better approaches to patient ventilator synchrony [ J ] ? Clin Chest Med, 2008,29 ( 2 ) : 329 - 342.
  • 5Dreher M, Kenn K, Windisch W. Non - invasive ventilation and physical exercise in patients with COPD[ J ]. Pneumologie, 2008,62 (3) :162 - 168.
  • 6Xirouchaki N, Kondili E, Vaporidi K, et al. Proportional assist ventilation with load- adjustable gain factors in critically ill patients: Comparison with pressure support [ J ]. Intensive Care Med, 2008,34 ( 11 ) : 2026 - 2034.
  • 7Greenough A, Premkumar M, Patel D. Ventilatory strategies for the extremely premature infant [ J ]. Paediatr Anaesth, 2008,18 ( 5 ) : 371 - 377.
  • 8Hummler H, Schulze A. New and alternative modes of mechanical ventilation in neonates [ J ]. Semin Fetal Neonatal Med, 2009,14 ( 1 ) : 42 - 48.
  • 9Thome U, Carlo W A, Pohlandt F. Ventilation strategies and out- come in randomised trials of high frequency ventilation [ J ]. Arch Dis Child Fetal Neonatal Ed,2005,90 (6) : F466-F473.
  • 10Younes M. Proportional assist ventilation, a new approach to ven- tilatory support. Theory[J]. Am Rev Respir Dis, 1992, 145( 1 ) : 114-120.

共引文献35

同被引文献142

  • 1张志刚,张彩云.密闭式吸痰系统在成人高频振荡机械通气患者气道管理中的临床研究[J].兰州大学学报(医学版),2013,39(3):53-55. 被引量:7
  • 2陈超.持续呼吸道正压通气在新生儿呼吸系统疾病中的应用[J].实用儿科临床杂志,2007,22(2):86-88. 被引量:109
  • 3邵肖梅,叶鸿瑶,丘小汕.实用新生儿学[M].4版.北京:人民卫生出版社,2011:807-808.
  • 4Jozwiak M,Silva S,Persichini R,et al.Extravascular lung water is an independent prognostic factor in patients with acute respi ratory distress syndrome[J].Crit Care Med,2013,41(2):472-480.
  • 5Melo MF,Bates JH.Pleural effusion in acute respiratory dis tress syn drome:water,water,everywhere,nor any drop to drain[J].Crit Care Med,2013,41(4):1133-1134.
  • 6Bereman MS,Tomazela DM,Heins HS,et al.A method to de termine the kinetics of multiple proteins in human infants with respiratory distress syndrome[J].Anal Bioanal Chem,2012,403(8):2397-2402.
  • 7Cardinal-Fernández P,Ferruelo A,El-Assar M,et al.Genetic predisposition to acute respiratory distress syndrome in patients with severe sepsis[J].Shock,2013,39(3):255-260.
  • 8喻文亮,钱素云,陶建平.新生儿高频通气[M].上海:上海科学技术出版社,2011:743~759.
  • 9Moriette G, Pariellado J, Waltih H, et al. Prospective ran- domized multicenter comparison of high - frequency oscilla- tory ventilation and conventional ventilation in preterm in- fants of less than 30 weeks with respiratory distress syndrome [J]. Pediatrics, 2001, 107(5):363-372.
  • 10Courtney S E, Durand D J, Asselin J M, et al. High fre- quency oscillatory ventilation versus conventional mechanical ventilation for very - low - birth - weight infants [ J ]. N En- gl J Med, 2002, 347(9) :643 ~652.

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