| 张 艳,李书芳,李艳民,蒋秀芳,雷延龄.NAVA模式与SIMV模式在新生儿呼吸窘迫综合症中的应用效果对比[J].,2018,(22):4362-4365 |
| NAVA模式与SIMV模式在新生儿呼吸窘迫综合症中的应用效果对比 |
| Comparison of the Application of NAVA Model and SIMV Model for the Neonatal Respiratory Distress Syndrome |
| 投稿时间：2018-07-08 修订日期：2018-07-30 |
| DOI：10.13241/j.cnki.pmb.2018.22.037 |
| 中文关键词: 呼吸窘迫综合症 新生儿 神经调节辅助通气 同步间歇指令通气 |
| 英文关键词: Respiratory distress syndrome Neonatal Neurally adjusted ventilatory assist Synchronized intermittent mandatory ventilation |
| 基金项目:河北省医学科学研究重点指导性计划项目(20160346) |
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| 中文摘要: |
| 摘要 目的：观察和比较神经调节辅助通气(NAVA)模式与同步间歇指令通气(SIMV)模式在新生儿呼吸窘迫综合症中的应用效果。方法：选择2015年3月至2017年3月我院接诊的94例呼吸窘迫综合征患儿，根据治疗方式不同分为观察组(n=47)和对照组(n=47)，均使用西门子公司生产的Servo-i呼吸机治疗，对照组使用SIMV模式，观察组使用NANA模式，连续治疗7天。比较两组治疗前后血氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)的变化，临床疗效及并发症的发生情况。结果：治疗后，两组PaO2、PaO2/FiO2均较治疗前显著升高，PaCO2较治疗前显著降低(P＜0.05)，观察组PaO2、PaO2/FiO2明显高于对照组[(69.12±4.10) vs. (55.74±3.65) mmHg，(256.81±28.11) vs. (212.75±26.35) mmHg]，PaCO2明显比对照组低[(45.81±3.04)mmHg vs. (50.03±3.15)mmHg](P＜0.05)。观察组临床疗效总有效率明显高于对照组[93.62%(44/47) vs. 74.47%(35/47)](P＜0.05)。两组气漏综合征、死亡发生率比较无显著差异(P＞0.05)，观察组呼吸机相关性肺损伤炎发生率明显低于对照组[4.26%(2/47)vs21.28%(10/47)](P＜0.05)。结论：和SIMV机械通气模式比较，NAVA模式用于呼吸窘迫症患儿的效果更加显著，其有助于改善血气分析，且可减少并发症的发生率。 |
| 英文摘要: |
| ABSTRACT Objective: To observe and compare the effect between neurally adjusted ventilatory assist(NAVA) model and synchronized intermittent mandatory ventilation(SIMV) model for neonatal respiratory distress syndrome. Methods: 94 cases of neonatal respiratory distress syndrome who were treated from March 2015 to March 2017 in our hospital were selected. According to different treatments, those patients were divided into the observation group (n=47) and the control group (n=47). They were treated by Servo-i ventilator produced by SIEMENS, the control group was treated with SIMV model, while the observation group was treated with NAVA model, both groups were continuously treated for 7d. The changes of partial pressure of oxygen (PaO2), carbon dioxide partial pressure (PaCO2) and oxygenation index (PaO2/FiO2) before and after treatment, the clinical efficacy and incidence of complications were compared between two groups. Results: After treatment, the PaO2 and PaO2/FiO2 of both groups were significantly higher than before treatment, and PaCO2 was significantly lower than those before treatment(P＜0.05), the PaO2 and PaO2/FiO2 in the observation group were significantly higher than those in the control group[(69.12±4.10) vs. (55.74±3.65) mmHg, (256.81±28.11) vs. (212.75±26.35) mmHg], the PaO2 was significantly lower than those in the control group[(45.81±3.04) vs. (50.03±3.15) mmHg](P＜0.05); the total effective rate of observation group was significantly higher than that in the control group[93.62%(44/47) vs. 74.47%(35/47)](P＜0.05); there was no significant difference between the two groups in the incidence of air leakage syndrome and mortality(P＞0.05), the incidence of ventilator associated lung injury in the observation group was significantly lower than that in the control group[4.26%(2/47) vs. 21.28%(10/47)](P＜0.05). Conclusion: Comparison with the SIMV mechanical ventilation model, NAVA model is more effective in the treatment of neonatal respiratory distress syndrome, which can improve the blood gas analysis and reduce the incidence of complications. |
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