【摘要】 目的探讨机械通气对极低出生体重儿脑室内出血的影响及机制。方法选取2003年1月至2005年12月在深圳市人民医院儿科住院的机械通气极低出生体重儿33例及同期住院的无机械通气极低出生体重儿33例,比较两者脑室内出血的发生率,并通过对机械通气下极低出生体重儿发生脑室内出血(11例)与无脑室内出血22例)的PIP、PEEP、MAP、通气天数及低血压比较,探讨机械通气对极低出生体重儿脑室内出血影响的发生机制。结果机械通气的极低出生体重儿脑室内出血和重度脑室内出血的发生率为66.7%和18.2%;无机械通气的极低出生体重儿脑室内出血发生率为33.3%,无重度脑室内出血。机械通气下极低出生体重儿发生脑室内出血与无脑室内出血者吸气峰压、呼吸末正压、平均气道压力、通气天数的比较无明显差异,当收缩压低于45mmHg时,极低出生体重儿发生脑室内出血较不发生脑室内出血明显增多。结论机械通气是导致极低出生体重儿脑室内出血发生和加重的危险因素,临床使用机械通气时,尽量维持患儿收缩压45mmHg以上,避免或减轻脑室内出血的发生或发展。更多还原

【Abstract】 Objective To study the influence and mechanics of mechanical ventilation on intracranial hemorrhage in very-low-birth-weight infant(VLBWI).Methods A total of 33 VLBWI with mechanical ventilation were selected and 33 VLBWI without mechanical ventilation were chosen at the same period as the control group from the cases in Neonatology Department of our hospital between January 2003 and December 2005.The rate of incranial hemorrhage between the two groups was compared.The 33 VLBWI with mechanical ventilation were divided into two groups:ICH group(11)and non-ICH group(22).The PIP,PEEP,MAP,days of ventilation and systolic hypopressure were compared between ICH group and non-ICH group.Results The rate of intracranial hemorrhage in VLBWI with mechanical ventilation was 66.7%,and the rate of severe intracranial hemorrhage was 18.2%.The rate of intracranial hemorrhage of control group was 33.3%,and there was no Ⅲ,Ⅳdegree intracranial hemorrhage.The rate of intracranial hemorrhage of VLBWI with mechanical ventilation was significantly higher and the degree was more serious than that of control group.There was no significant difference for PIP,PEEP,MAP,and days of ventilation between ICH group and non-ICH group.When the systolic pressure was below 45mmHg,the happening of incranial hemorrhage was more significant.Conclusion Mechanical ventilation is the risk factor for intracranial hemorrhage of VLBWI.Try to maintain the systolic pressure above 45mmhg to avoid or relieve the happening and processing of intracranial hemorrhage when mechanical ventilation is used.更多还原