同步间歇指令通气治疗新生儿急性肺损伤的探讨

目的:探讨同步间歇指令通气(SIMV)较传统通气治疗新生儿急性肺损伤的优越性及其临床应用价值.方法:62例因急性肺损伤需用机械通气治疗的新生儿,32例用同步间歇指令通气(SIMV);30例用间歇正压通气(IPPV).将两组患儿的呼吸机参数氧浓度(FiO2)、吸气峰压(PIP)和肺氧合功能指标在0、2、6、12、24 h进行组内比较,并比较两组患儿平均上机时间以及并发症的多少.结果:SIMV组在上机后6 h FiO2、PIP有显著下降(P＜0.05).而IPPV组在上机12 h FiO2开始下降、上机24 h PIP才有显著下降(P＜0.05).上机2 h SIMV组肺氧合功能指标较上机前明显改善,差异显著(P＜0.05),而IPPV组在上机后6 h出现显著改变.SIMV组平均上机时间明显缩短(P＜0.05),机械通气并发症也较IPPV组明显减少(P＜0.05).结论:需用机械通气的新生儿,SIMV通气方式能更快地降低FiO2和PIP,改善通气和氧合,缩短上机时间,减少并发症的发生率.

Use of synchronized intermittent mandatory ventilation in the treatment of neonatal acute lung injury

Objective:To review the experience of using synchronized intermittent mandatory ventilation(SIMV) in the treatment of neonatal acute lung injury. Methods:Sixty-two neonates suffering from acute respiratory distress syndrome and requiring mechanical ventilation were devided into two groups,32 by SIMV and 30 by intermittent positive pressure ventilation(IPPV). FiO2,PIP,oxygenation index,average time of ventilation and complications were compared between the two groups. Results:FiO2 and PIP dropped in 6 hours of ventilation in SIMV group. Oxygenation index was obviously improved 2 h after use of SIMV and 6 h after use of IPPV. Average time of ventilation was shorter in SIMV group than in IPPV group. The rate of complications was less in SIMV group than in IPPV group. Conclusion:SIMV was superior to IPPV in the treatment of neonatal acute lung injury.