机械通气下极低出生体重儿颅内出血相关因素分析

目的:探讨机械通气下极低出生体重儿(VLBW I)发生颅内出血的相关因素。方法:以NICU收治的机械通气治疗的VLBW I为研究对象,分为颅内出血组和无出血组进行对比分析。结果:颅内出血发生率为47.2%,两组VLBW I孕周越小,上机时间越早,持续时间越长者,越易发生颅内出血。而两组患儿出生体重、1分钟及5分钟Apgar评分均无显著差别(P>0.05);两组的最高FIO2、PIP、PEEP均无显著差别(P>0.05);两组患儿上机前后血气分析PCO2最高及最低值均无显著差别(P>0.05)。结论:在VLBW I需机械通气治疗时,除严格掌握机械通气的指征外,应尽早使用外源性肺表面活性物质,以延迟开始上机时间,缩短用机持续时间,并采取肺保护性通气策略,可减少机械通气下的VLBW I发生颅内出血。

Analysis of factors of intracranial hemorrhage of very-low birth-weight infants during mechanical ventilation

Objective:To investigate the relative factors of intracranial hemorrhage(ICH) of very-low birth-weight infants(VLBWI) during mechanical ventilation.Methods:VLBWI with mechanical ventilation who were admitted in NICU of authors' hospital were divided into ICH group and no ICH group and were analyzed.Results:The incidence of ICH was 47.2%.There was a closed relationship between ICH and low gestational age,early respirator applied,and the long continuous period of mechanical ventilation.There were no significant difference in the highest values of FiO2,PIP,PEEP,and the highest and lowest values of PaCO2 between the two groups(P>0.05).Conclusion:When VLBWI need mechanical ventilation therapy,pulmonary surfactant should be applied as early as possible,while the exact indication of applied respirator be managed,so the time of the started-mechanical ventilation will be delayed and the period of mechanical ventilation will be shortened.And then,protective ventilation strategy will be decreased the incident of intracranial hemorrhage of VLBWI during mechanical ventilation.