同步间歇指令通气辅以压力支持治疗新生儿胎粪吸入综合征的效果与护理

目的探讨同步间歇指令通气（SIMV）联合压力支持（PS）对新生儿胎粪吸入综合征（NMAS）患儿的治疗效果及护理体会。方法将40例NMAS患儿按通气模式不同分为对照组和观察组各加例。对照组患儿接受SIMV，观察组患儿接受SIMV＋PS；观察两组患儿吸氧时间、机械通气时间及住院时间；观察治疗后平均动脉压（MABP）、平均气道压（MAP）及氧合指数（OI）的变化。结果观察组吸氧时间、机械通气时间、住院时间分别为（4．9±1．1）d，（65．7±7．0）h，（7．9±1．4）d，均低于对照组的（5．6±0．7）d，（75．1±9．2）h，（10．1±2．0）d，差异有统计学意义（t值分别为2．401，3．636，4．030；P〈0．05）；两组治疗前后MABP均较平稳；观察组治疗后36hMAP、01分别为（7．4±0．9）cmH2O，（4．7±1．8），均低于对照组的（8．1±1．1）cmH：0，（10．1±3．4），差异有统计学意义（t值分别为2．203，6．698；P〈0．05）。结论应用SIMV＋Ps，能改善患儿氧合，降低平均动脉压和气道压，利于早日脱机及减少通气总时间。严密观察患儿病情，做好气道护理可提高治疗效果。

Effect of synchronized intermittent mandatory ventilation combined with pressure support on neonatal meconium aspiration syndrome and its nursing

Objective To discuss the clinical effect of synchronized intermittent mandatory ventilation （SIMV） combined with pressure support （PS） on neonatal meconium aspiration syndrome （NMAS） and its nursing. Methods Forty cases of NMAS children were divided into the control group and the observation group according to the ventilation mode, each with 20 cases. The control group received SIMV while the observation group received SIMV with PS. Oxygen time, duration of mechanical ventilation and length of stay were observed, and changes of mean arterial pressure （ MABP）, mean airway pressure （MAP） and oxygenation index （OI） were observed after treatment. Results Time of oxygen, mechanical ventilation and length of stay was significantly shorter than those in the control group （4.9 ± 1.1 ） d vs （ 5.6 ± 0.7 ） d, （65.7±7.0） h vs （75.1 ±9.2） h, （7.9 ±1.4） d vs （10. 1 ±2.0） d], and the differences were statistically significant （t = 2.401,3. 636,4. 030, respectively; P 〈 0. 05）. Before treatment, MABP in both groups was stable. After 36 hours of treatment, the MAP and OI was （7.4 ± 0.9） cmH20 and （4.7 ± 1.8 ） in the observation group, lower than （8.1 ± 1.1 ）cmH20 and（ 10. 1 ± 3.4）in the control group, and the differences were statistically significant （t = 2. 203,6. 698, respectively;P 〈 0. 05 ）. Conclusions SIMV combined with PS ventilation can improve children＇s oxygenation and reduce mean arterial pressure and airway pressure ventilation, which is conducive to the early offline and reduce ventilation time. Close attention to patients＇ status and airway nursing can improve the therapeutic effect.