早产儿呼吸衰竭同步机械通气治疗的呼吸力学评价

目的 :探讨同步间歇指令性通气 (SIMV)在早产儿机械通气中的临床意义。方法 :4 2例机械通气的早产儿随机分成两组 ,SIMV组 2 4例 ,IMV组 18例 ,观察两组呼吸机参数、呼吸力学参数的变化情况、并发症的发生率及镇静剂的使用次数并比较。结果 :上机 2 h后 PIP、VTexp、Crs、Raw,12 h后 Fi O2 SIMV组明显优于 IMV组 ,2 4 h OI在SIMV组明显小于 IMV组 ;镇静剂的使用次数 SIMV组小于 IMV组 ,两组差异有显著性 (P<0 .0 5 ) ;并发症的发生率两组差异无显著性 (P>0 .0 5 )。结论 :早产儿呼吸衰竭机械通气时使用 SIMV模式与 IMV比较 ,前者能更快降低 Fi O2 、PIP、OI,较快改善肺功能 ,减少镇静剂和肌松剂的使用率。

A Clinical Respiratory Mechanics Study on Synchronize Intermittent Mandatory Ventilation (SIMV) in Ventilated Premature with Respiratory Failure

Objective:To evaluate the clinical significance of synchronized intermittent mandatory ventilation (SIMV) in ventilated prematures.Methods:42 prematures were studied(SIMV set 24 and intermittent mandatory ventilation (IMV) set 18). The parameters of FiO_2PIP VTexpOICrs and Raw were compared .The frequency of sedatives used, incidence rate of complications were also compared between two groups.Results:In SIMV group, PIPVTexpRaw and Crs were significantly different after 2 hours ventilation(P<0.05). FiO_2 and OI were significantly different after 12 hours and at 24 hours in two groups .The times of sedatives used in SIMV group were less than those in IMV group(P<0.05).Conclusion:In ventilated prematures, SIMV could reduce FiO_2PIP OIRaw and improve VTexp Crs more rapidly.the sedatives used in SIMV were also obviously reduced.