摘要
目的 探讨早产儿脑室周围白质软化 (PVL)与机械通气下低碳酸血症的关系。 方法 对合并PVL和未合并PVL的胎龄 2 6～ 3 2周早产儿各 2 5例 ,进行对照研究。对生后前 3d机械通气参数和血气指标进行比较。 结果 两组生后前 3d机械通气参数吸气峰压、呼气末正压、平均气道压、呼吸频率差异均无显著性。PVL组和对照组低氧血症的持续时间分别为 (3 .7± 1.1)和(4.1± 1.3 )h ,两组差异无显著性 (P >0 .0 5)。PVL组和对照组生后 72h最低PaCO2 分别为 (2 3 0±1.2 )mmHg (1mmHg =0 .13 3kPa)和 (3 1 0± 7.6)mmHg ;低碳酸血症的持续时间分别为 (2 6.3±7.8)和 (1.7± 0 .4)h ;两组差异有非常显著性 (P <0 .0 1)。最低PaCO2 ≤ 2 5mmHg时 ,病例对照研究的比值比 (OR)为 16.6(95% ,可信限为 4.1～ 67.4,P <0 .0 1)。 结论 机械通气下的低碳酸血症与早产儿PVL密切相关。生后 72h内PaCO2 低于 2 5mmHg 。
ObjectiveTo investigate the relation between h yp ocarbia and periventricular leukomalacia (PVL) in preterm infants treated with m echanical ventilation.MethodsCase-controlled study was cond ucted in 25 preterm infants with PVL(PVL group) and 25 preterm infants normal de veloped(control group). Their gestational age were 26 to 32 weeks. The parameter s of mechanical ventilation and blood gas analysis within the first 3 days were compared.ResultsThere were no significantly difference in pa rameters of ventilator settings, including peak inspiratory pressure, positive e nd-expiratory pressure, mean airway pressure and respiratory rate between PVL g roup and control group. The duration of hypoxemia in PVL and control group had n o difference, (3.7±1.1)h vs(4.1±1.3) h (P>0.05). The minimum PaCO 2 (minPaCO 2) within the first 72 h of life and duration of hypocarbia in PVL and control group were (23 0±1.2) mm Hg vs (31 0±7.6) mm Hg, and (26 .3 ±7.8) h vs (1.7±0.4) h, (P<0.01) respectively. Odds ratios of min PaCO 2 below 25 mm Hg was 16.6 (95% CI: 4.1～67.4, P<0.01).Conclu s ionHypocarbia is associated closely with PVL in preterm infants treate d with mechanical ventilation. The risk of PVL increases significantly when minP aCO 2 is lower than 25 mm Hg in the first 72 hours of life.
出处
《中华围产医学杂志》
CAS
2003年第6期329-332,共4页
Chinese Journal of Perinatal Medicine
