新生儿呼吸机相关性肺炎患儿采用俯卧位通气治疗的临床观察

云忠明1，姜东妮2

（1. 陕西省榆林市神木县医院，陕西 榆林，719300；2.陕西省西安市户县妇幼保健院，陕西 西安，710300）

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摘要：

目的 探究俯卧位通气（PPV）在新生儿呼吸机相关性肺炎（VAP）患儿治疗中的应用效果。方法 选择我院2013年6月至2016年6月收治的80例新生儿VAP患儿为研究对象，按照治疗方法不同分为对照组和研究组，各40例。对照组给予患儿仰卧位通气治疗，研究组患儿采用PPV治疗，比较两组患儿的治疗效果。结果 治疗后，研究组的PaO₂、PaO₂/FiO₂、PaO₂/PAO₂ 水平明显高于对照组，A-aDO₂水平明显低于对照组，差异具有统计学意义（P<0.05）；两组间RR、PaCO₂ 水平比较，差异没有 统计学意义（P>0.05）。治疗第1 天，两组患儿PCT水平、CPIS评分比较，差异没有统计学意义（P>0.05）；治疗第5天，研究组患儿PCT水平及CPIS评分显著降低（P<0.05），且研究组PCT水平、CPIS评分明显低于对照组（P<0.05）。结论 实施PPV治疗新生儿VAP，能够显著改善患儿的氧合情况，减轻患儿的感染程度，治疗效果更佳，可进行推广使用。

关键词：新生儿；呼吸机相关性肺炎；俯卧位通气；仰卧位通气

中图分类号：R725.5文献标志码：A文章编号：2096-1413(2017)27-0093-02

Clinical observation of prone position ventilation on newborns with ventilator-associated pneumonia
YUN Zhong-ming 1, JIANG Dong-ni 2
(1. Shenmu County Hospital, Yulin 719300; 2. Hu County Maternal and Child Health Care Hospital, Xi``an 710300, China)

ABSTRACT: Objective To investigate the application effect of prone position ventilation (PPV) on newborns with ventilator-associated pneumonia (VAP). Methods Eighty newborns with VAP in our hospital from June 2013 and June 2016 were selected as the study objects. These newborns were divided into the control group and the study group, according to the therapy methods, with 40 newborns in each group. The control group was treated with supine position ventilation, while the study group received PPV. The therapeutic effects of the two groups were compared. Results After treatment, the levels of PaO2、PaO2/FiO2、PaO2/PAO2 in the study group were significantly higher than those in the control group (P<0.05), the A-aDO2 level in the study group was lower than that in the control group (P<0.05). The differences of RR and PaCO2 levels between the two groups were not statistically significant (P>0.05). On the first day of treatment, there were no significant differences between the two groups in PCT levels and CPIS scores (P>0.05). After 5 th days treatment, the PCT levels and CPIS scores in the two groups obviously reduced, and the PCT levels and CPIS scores in the study group were significantly lower than those in the control group (P<0.05). Conclusion PPV treatment of VAP on newborns can significantly improve oxygenation in children, reduce the degree of infection, and have better treatment effect, which can be popularized.
KEYWORDS: newborns; VAP; PPV; supine position ventilation

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