摘要
目的研究血氧分压在胎粪吸入综合征所致肺动脉高压治疗中的指导作用。方法回顾性分析2007年1月1日至2016年12月31日收治胎粪吸入并肺动脉高压患儿58例,死亡组28例,存活组30例。采集两组患儿有创机械通气治疗中使用呼吸机前(0h)、机械通气后12h、机械通气后24h及机械通气后72h血气分析结果做对比研究,并以血气分析中血氧分压80mmHg(1mmHg=0.133kPa)为界值点,研究不同的血氧分压对存活组患儿机械通气时间长短的影响。结果两组患儿在机械通气治疗前pH、血氧分压、HCO3-、乳酸无明显差异,但pH值在机械通气12h、24h及72h后存活组较死亡组明显升高,差异均有统计学意义(t值分别为-2.07、-3.48、-7.11;P均<0.05)。存活组12h、24h及72h氧分压高于死亡组(t值分别为-2.87、-4.88、-11.29;P均<0.05)。存活组在12h、24h及72h三个时间点的HCO3-值高于死亡组,差异有统计学意义(t值分别为-3.90、-5.60、-5.76;P均<0.001);存活组乳酸在通气治疗72h明显低于死亡组(t=5.12,P<0.001)。在机械通气治疗24h、72h后,存活组中血二氧化碳分压低于死亡组,差异有统计学意义(t值分别为5.67、7.60;P<0.05)。存活组中血氧分压维持在80mmHg以上组(18例)机械通气时间(7.17±1.95)d,短于80mmHg以下组(12例)机械通气时间(8.67±2.50)d,差异有统计学意义(t=12.02,P<0.001)。结论胎粪吸入致肺动脉高压患儿治疗中,维持患儿较高的pH值,且维持大于80mmHg的血氧分压将有利于肺动脉高压患儿的恢复。
Objective To study the role of partial pressure of oxygen in the treatment of pulmonary hypertension induced by meconium aspiration syndrome. MethodsRetrospective analysis was performed on 58 patients with meconium aspirate and pulmonary hypertension from January 1, 2007 to December 31, 2016, 28 patients in the death group, and 30 patients in the survival group.Blood gas analysis about two groups of children with mechanical ventilation were collected at four different time points: before mechanical ventilation (0 h), 12 hours after mechanical ventilation, 24 hours after mechanical ventilation and 72 hours after mechanical ventilation.The 80 mmHg(1 mmHg=0.133 kPa) in blood gas analysis of the partial pressure of oxygen was used as the boundary point to study the effects about different blood oxygen partial pressures on the length of mechanical ventilation time in the survival group. ResultsBlood gas analysis showed that there were no significant differences in pH, partial pressure of oxygen, HCO3-, and lactic acid before mechanical ventilation in the two groups, but the pH values were significantly higher in the survival group after 12 h, 24 h, and 72 h of mechanical ventilation(t values: -2.07, -3.48, -7.11;P<0.05). Partial pressure of oxygen were higher in the surviving group at 12 h, 24 h, and 72 h than those in the death group(t values -2.87, -4.88, -11.29;P<0.05). The HCO3-values of the survival group at 12 h, 24 h and 72 h were higher than the death group, and the differences were statistically significant (t values: -3.90, -5.60, -5.76, P<0.001). The lactic acid of survival group was significantly lower than the death group at 72 h after ventilation (t=5.12, P<0.001). Compared with the death group, partial pressure of carbon dioxide in 24 h, 72 h decreased significantly in the surviving group(t values: 5.67, 7.60;P<0.05). In the surviving group, the partial pressure of oxygen was maintained above 80 mmHg in 18 patients and the mechanical ventilation time was (7.17±1.95) d. The partial pressure of oxygen wa
作者
花少栋
迟明
陈冲
樊燕宇
梅亚波
封志纯
Hua Shaodong;Chi Ming;Chen Chong;Fan Yanyu;Mei Yabo;Feng Zhichun(Army General Hospital Affiliated Bayi Children′s Hospital NICU, National Engineering Laboratory of Key Technologies for Birth Defect Prevention and Control, Beijing Key Laboratory of Organ Failure in Children, Beijing 100007, China;Department of Pediatrics, First Affiliated Hospital of PLA General Hospital, Beijing 100031, China;Department of Neonatology, Chongqing Maternal and Child Health Hospital, Chongqing 400013, China)
出处
《中国小儿急救医学》
CAS
2019年第1期51-55,共5页
Chinese Pediatric Emergency Medicine
基金
国家自然科学基金(81401248).
关键词
胎粪吸入综合征
肺动脉高压
血气分析
血氧分压
Meconium aspiration syndrome
Pulmonary hypertension
Blood gas analysis
Partial pressure of oxygen
