| 摘要: |
| 目的:探讨同步间歇通气(SIMV)+压力支持通气(PSV) +目标容量通气(TTV)模式对新生儿呼吸窘迫综合征血气指标的影响及与高迁移率族蛋白1(HMGB1)的相关性。方法:分析2016年7月至2017年8月在我院接受治疗的87例呼吸窘迫综合征新生儿(NRDS)的临床资料,按照通气模式的不同分为两组,观察组患儿41例,采用SIMV+PSV+TTV模式,对照组患儿46例采用SIMV+辅助/控制通气(A/C)模式,观察两组患儿血气指标、HMGB1水平,症状、体征好转时间,不良反应发生情况及预后。结果:观察组治疗后48 h的氧分压/吸入氧浓度、肺泡/动脉血氧分压高于对照组,血清HMGB1水平低于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,观察组治疗后48 h的氧分压/吸入氧浓度、肺泡/动脉血氧分压升高明显,血清HMGB1水平则降低,差异均有统计学意义(P<0.05);观察组住院时间、有创通气时间明显低于对照组,差异有统计学意义(P<0.05);两组患儿治疗后低碳酸血症、呼吸机相关肺炎、脑室周围白质软化、气胸发生率比较差异均有统计学意义(P<0.05);观察组治疗48 h血清HMGB1水平与氧分压/吸入氧浓度、肺泡/动脉血氧分压均呈负相关(r分别为-0.792、-0.637,P均<0.05),对照组治疗48 h血清HMGB1水平与氧分压/吸入氧浓度、肺泡/动脉血氧分压无线性相关关系。结论:SIMV+PSV+TTV 模式可改善NRDS患儿呼吸功能,促进肺泡氧合功能恢复,降低患儿机械通气时间,减少机械通气并发症的发生。 |
| 关键词: 同步间歇通气 压力支持通气 目标容量通气 新生儿呼吸窘迫综合征 高迁移率族蛋白1 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.09.003 |
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| 基金项目:阳江市科技计划项目,社发[2017]48号。 |
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| SIMV, PSV Combined with TTV Model on Blood Gas Indexes of Neonatal Respiratory Distress Syndrome and Its Correlation with HMGB1 |
| Mo Guohuan, Xie Yimin, Lin Xuexia, Chen Fengxi |
| (Yangjiang Maternal and Child Health Hospital, Guangdong Yangjiang 529500, China) |
| Abstract: |
| Objective: To probe into the effects of synchronized intermittent mandatory ventilation (SIMV), pressure support ventilation (PSV) combined with target volume ventilation (TTV) model on blood gas indexes of neonatal respiratory distress syndrome and correlation with high mobility group box-1 protein (HMGB1). Methods: Clinical data of 87 neonatal respiratory distress syndrome (NRDS) admitted into our hospital from Jul. 2016 to Aug. 2017 were analyzed. According to different ventilation model, all neonates were divided into observation group (n=41) and control group (n=46); the observation group was given SIMV, PSV combined with TTV model while the control group received SIMV and assist/ control ventilation (A/C) model. Results: The oxygen partial pressure/ inhalation oxygen concentration and alveolar/arterial oxygen partial pressure of the observation group were higher than those of the control group at 48 h after treatment, and the serum HMGB1 level was lower than that of the control group, the difference was statistically significant (P<0.05). Compared with before treatment, the oxygen partial pressure/inhaled oxygen concentration, alveolar/arterial oxygen partial pressure increased significantly in the observation group at 48 h after treatment, and the serum HMGB1 level decreased, with statistically significant differences (P<0.05). The hospitalization time and invasive ventilation time of observation group were significantly lower than those of control group, the difference was statistically significant (P<0.05). The differences of the incidence of hypocapnia, ventilator-associated pneumonia, periventricular leukomalacia, pneumothorax in both groups after treatment were statistically significant (P<0.05). The serum HMGB1 levels in observation group were negatively correlated with the oxygen partial pressure/inhaled oxygen concentration and the alveolar/arterial partial pressure of oxygen (r were respectively -0.792 and -0.637, P<0.05). There was no linear correlation between serum HMGB1 levels and oxygen partial pressure/inhaled oxygen concentration, and alveolar/arterial partial pressure of oxygen in control group. Conclusion: SIMV, PSV combined with TTV model can improve the respiratory function of NRDS, promote the recovery of alveolar oxygenation, reduce the time of mechanical ventilation and the incidence of complications of mechanical ventilation. |
| Key words: synchronized intermittent mandatory ventilation pressure support ventilation target volume ventilation neonatal respiratory distress syndrome high mobility group box-1 protein |
