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目的探讨压力调节容量通气(PRVC)治疗婴幼儿呼吸衰竭的疗效及安全性。方法将98例呼吸衰竭新生儿随机分为PRVC组52例和间歇指令通气(IMV)组46例,对比分析两组气道峰压(PIP)、平均气道压(Pmean)、动脉血气、疗效、并发症发生率及上机时间。结果①PRVC组上机时间(67.62±22.63)h明显低于IMV组的(88.78±25.88)h,差异有显著统计学意义(P<0.01)。②PRVC组治愈率92.3%,明显高于IMV组的78.3%,差异有统计学意义(P<0.05)。③在通气治疗1h后PRVC组的PIP、Pmean和FiO2明显低于IMV组(P<0.05),12h、24h后更加明显(P<0.01);两组PaO2及通气治疗24h的PH值和PaCO2比较差异无统计学意义(P>0.05),但PRVC组PaCO2在通气治疗1h、12h明显低于IMV组(P<0.05),pH值在通气治疗1h、12h明显高于IMV组(P<0.05)。结论 PRVC治疗新生儿呼吸衰竭比IMV具有优越性,是一种疗效肯定、安全性较好的机械通气方法,是目前呼吸机中较科学和理想的一种通气模式。
Objective To investigate the efficacy and safety of pressure-controlled ventilation (PRVC) in the treatment of respiratory failure in infants and young children. Methods A total of 98 neonates with respiratory failure were randomly divided into PRVC group (n = 52) and intermittent mandatory ventilation group (n = 46). The PIP, Pmean and arterial blood gases were compared between the two groups , The incidence of complications and on-machine time. Results ① The up time of PRVC group (67.62 ± 22.63) h was significantly lower than that of IMV group (88.78 ± 25.88) h, the difference was statistically significant (P <0.01). ② The cure rate of PRVC group was 92.3%, which was significantly higher than that of IMV group (78.3%), the difference was statistically significant (P <0.05). PIP, Pmean and FiO2 in PRVC group were significantly lower than those in IMV group (P <0.05) after ventilation for 1h, and more significantly after 12h and 24h (P <0.01) (P <0.05). However, PaCO2 in PRVC group was significantly lower than that in IMV group (P <0.05) at 1h and 12h after ventilation and the pH was significantly higher at 1h and 12h after ventilation than that of IMV group (P <0.05) . Conclusion PRVC is superior to IMV in treating neonatal respiratory failure. It is a more effective and safe mechanical ventilation method and is the more scientific and ideal ventilatory mode in ventilator.