间歇正压通气对极低出生体重儿有创呼吸机脱机拔管的价值

探讨间歇正压通气对极低出生体重儿有创呼吸机脱机拔管的临床价值。方法　选择极低体重儿８０例，按照随机数字法分为两组，观察组患儿在拔除气管导管后立即使用婴儿呼吸机进行间歇正压通气，对照组使用面罩氧，比较两组机械通气相关指标、治疗后血气分析结果及乳酸水平变化情况及治疗过程中发生的不良反应。结果　观察组机械通气时间、拔管后呼吸暂停时间及拔管后发绀持续时间均显著短于对照组（Ｐ＜００５），治疗后，观察组ｐＨ水平高于对照组（Ｐ＜００５），ＰＣＯ２水平低于对照组（Ｐ＜００５），ＰＯ２水平高于对照组（Ｐ＜００５），血乳酸水平低于对照组（Ｐ＜００５），两组发生腹胀、胃潴留，呼吸道干燥及返流的差异无统计学意义（Ｐ＞００５）。结论　鼻塞间歇正压通气能显著逆转缺氧及二氧化碳蓄积，利于顺利撤离有创呼吸机，且不增加不良反应。

The clinical value of invasive ventilator offline extubation for intermittent positive pressure ventilation in very low birth weight children

To investigate the clinical value of invasive ventilator offline extubation for intermittent positivepressure ventilation in very low birth weight children. Methods 80 cases of very low birth weight children were random-ly divided into two group, the observation group were immediately after extubation infant ventilator intermittent positivepressure ventilation , the control group were used an oxygen mask .Results There were mechanical ventilation, apnea af-ter extubation time and duration of cyanosis after extubation in the observation group were shorter than control group ( P < 0. 05 ) . after treatment, the pH level in the observation group was higher than control group ( P < 0. 05 ) , PC02 inthe observation group was lower than control group ( P < 0. 05 ) . P02 level in the observation group was higher than con-trol group (P < 0. 05 ) , blood lactate in the observation group was higher than control group ( P < 0. 05 ) , two group withabdominal distention, gastric retention, respiratory and dried reflux had no difference ( P > 0. 05 ). Conclusion Nasalintermittent positive pressure ventilation can significantly reverse the accumulation of oxygen and carbon dioxide and con-ducive the smooth withdrawal of invasive ventilator, and it has no increase in adverse reactions.