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目的 探讨同步间歇指令通气 (SIMV)治疗新生儿肺透明膜病 (HMD)的疗效。方法 对 4 5例HMD患儿进行SIMV ,观察上机后的临床表现、动脉血气变化及并发症的发生。结果 35例于实施SIMV后 ,青紫即刻减轻或消失 (77 8% ) ,34/ 4 5例 (75 6 % )吸气呼吸困难减轻 ;6h内动脉血氧分压由 (5 84± 1 0 6 )kPa升高至(8 15± 2 2 2 )kPa ,动脉血二氧化碳分压由 (7 32± 1 6 8)kPa降低至 (5 70± 1 4 2 )kPa ,血氧饱和度由 6 7 87±11 75升高至 86 6 7± 7 75 ,pH值由 7 2 1± 0 0 9升高至 7 35± 0 0 5。 38/ 4 5例 (84 4 % )HMD患儿被治愈 ,死亡3/ 4 5例 (6 7% ) ,4例自动出院。结论 SIMV模式对HMD有良好疗效 ,值得临床推广。
Objective To investigate the efficacy of synchronous intermittent mandatory ventilation (SIMV) in the treatment of neonatal hyaline membrane disease (HMD). Methods 45 cases of HMD children with SIMV, observed after the clinical manifestations, arterial blood gas changes and complications. Results After the SIMV was performed in 35 patients, the cyanosis reduced or disappeared immediately (77.8%), while 34/45 (75.6%) patients had reduced inspiratory difficulty breathing. The arterial partial pressure of oxygen was decreased from (544 ± 106) ) kPa increased to (8 15 ± 2 2 2) kPa, the partial pressure of arterial carbon dioxide decreased from (7 32 ± 1 6 8) kPa to (5 70 ± 1 4 2) kPa, and the oxygen saturation increased from 67 7 87 ± 11 75 to 86 6 7 ± 7 75, and the pH increased from 7 2 1 ± 0 0 9 to 7 35 ± 0 0 5. 38/45 5 (84.4%) children with HMD were cured, 3/4 5 (67%) died and 4 patients were discharged automatically. Conclusions The SIMV model has good curative effect on HMD and worthy of clinical promotion.