摘要
目的:探究不同给氧方式对早产儿颅脑多普勒超声血流参数的影响。方法:选择医院收治的60例早产儿,根据随机数表法将其分为头罩吸氧组、鼻导管吸氧组和呼吸机吸氧组,每组20例,头罩吸氧组采用头罩吸氧方式,鼻导管吸氧组采用鼻导管吸氧方式,呼吸机吸氧组采用持续性正压(CPAP)呼吸机吸氧方式。检测并对比各组吸氧前后患儿脑血流与血气的变化。结果:头罩吸氧组患儿吸氧后大脑中动脉舒张末期流速(EDV)值低于吸氧前,而阻力指数(RI)高于吸氧前,差异有统计学意义(t=4.990,t=7.333;P<0.05);吸氧后的血气中pH值、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、碱剩余(BE)、碳酸氢根(HCO_(3)^(-))及动脉血氧饱和度(SaO_(2))明显改善,与吸氧前比较差异有统计学意义(t=2.768,t=3.559,t=2.483,t=2.149,t=20.954,t=4.198;P<0.05);鼻导管吸氧组患儿吸氧后收缩期峰值流速(PSV)及EDV值明显下降,而RI值明显升高,与吸氧前比较,差异有统计学意义(t=8.221,t=5.956,t=17.155;P<0.05)。鼻导管吸氧组吸氧后的血气检测指标中pH值、PaO_(2)、PaCO_(2)、BE、HCO_(3)^(-)及SaO_(2)均有明显的改善,与吸氧前比较差异有统计学意义(t=5.114,t=5.249,t=3.257,t=2.455,t=2.970,t=4.020;P<0.05);CPAP呼吸机吸氧后患儿的PSV及EDV变化与吸氧前比较明显下降,而血流RI的变化与吸氧前比较明显升高,差异有统计学意义(t=7.627,t=3.955,t=11.388;P<0.05);呼吸机吸氧组吸氧后患儿血气分析中pH值、PaO_(2)、PaCO_(2)、BE、HCO_(3)^(-)及SaO_(2)指标明显得到改善,与吸氧前比较差异有统计学意义(t=7.719,t=7.266,t=7.202,t=2.760,t=2.806,t=13.372;P<0.05);呼吸机吸氧组治愈率最高为75%,与其他两组比较差异有统计学意义(x^(2)=6.674,P<0.05)。结论:头罩吸氧、鼻导管吸氧和CPAP呼吸机吸氧3种不同的给氧方式均可以影响早产儿多普勒超声血流参数的变化,可调节脑血流紊乱,改善脑部缺氧缺血,�
Objective:To explore the effects of different ways of oxygen inhalation on the blood flow parameters of Doppler ultrasound on brain of premature infants.Methods:60 premature infants who admitted to hospital were selected,and they were divided into group of oxygen inhalation with head mask,group of oxygen inhalation with nasal catheter and group of oxygen inhalation with ventilator,with 20 cases in each group.The group of oxygen inhalation with head mask adopted head mask method,and group of oxygen inhalation with nasal catheter adopted nasal catheter,and group of oxygen inhalation with ventilator adopted continuous positive airway pressure(CPAP)ventilator.The changes of detected cerebral blood flow and blood gas of patients in each group between before and after oxygen inhalation were compared.Results:In group of oxygen inhalation with head mask,the end diastolic velocity(EDV)values of the cerebral artery of the patients after oxygen inhalation was significantly lower than that before oxygen inhalation,while the resistance index(RI)value after oxygen inhalation was significantly higher than that before oxygen inhalation(t=4.990,t=7.333,P<0.05).And compared with those before oxygen inhalation,the levels of pH,PaO_(2),PaCO_(2),BE,HCO_(3)^(-)and SaO_(2)of blood gas were significantly improved after oxygen inhalation in group with oxygen inhalation with head mask(t=2.768,t=3.559,t=2.483,t=2.149,t=20.954,t=4.198,P<0.05),respectively.In group of oxygen inhalation with nasal catheter,the peak systolic velocity(PSV)and EDV of patients significantly decreased,while the RI value increased significantly after oxygen inhalation,the differences of them between before and after oxygen inhalation were statistically significant(t=8.221,t=5.956,t=17.155,P<0.05).And the levels of pH,PaO_(2),PaCO_(2),BE,HCO_(3)^(-)and SaO_(2)of group of oxygen inhalation with nasal catheter after oxygen inhalation were significantly improved,and the differences of them between before and after oxygen inhalation were significant(t=5.114,t=5.249,t=3.
作者
邱文慧
邓玲灵
陈慧贞
周小雅
张扬
曾燕静
QIU Wen-hui;DENG Ling-ling;CHEN Hui-zhen(不详;Department of Medical Technique,The First Affiliated Hospital of Guangzhou University of Chinese medicine,Guangzhou 510000,China)
出处
《中国医学装备》
2022年第7期84-88,共5页
China Medical Equipment
基金
广东省卫生健康管理委员会基金项目(WJ2019F174)“不同吸氧方式对新生儿脑血流的影响及临床价值研究”。
关键词
给氧方式
颅脑损伤
缺氧缺血性脑病
经颅多普勒超声
血流参数
Oxygen inhalation mode
Craniocerebral injury
Hypoxic ischemic encephalopathy
Doppler ultrasound
Blood flow parameter
