人工肺通气及胃内容物微吸参数对新生儿肺炎发生频率的影响

E. Bryksina, A. Pochivalov, V. Bryksin
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引用次数: 0

摘要

新生儿期疾病结构中最常见的传染病之一是肺炎。使用人工肺通气(APV)的新生儿在发展过程中进入呼吸机相关性肺炎(VAP)的危险组,其发生频率随着人工肺通气持续时间的增加而增加。可以确定的是,在大多数情况下,使用APV的新生儿都有胃内容物微吸,这与真正研究的目的有关:研究APV和胃内容物微吸对新生儿肺炎的发生频率和病程特征的影响。材料和方法。该研究包括177名接受呼吸治疗的新生儿。根据气管支气管抽吸(TBA)中胃的定义估计微吸的表达性。VAP的诊断是在参考临床和放射学标准的基础上建立的。研究的主要结果。结果表明,使用“刚性”参数APV的新生儿出现胃内容物微吸性肺炎的频率更高。合并微吸和肺炎的患者APV和随后的kislorodoterapiya持续时间最长。在新生儿期严重呼吸挫折的起源中,呼吸道“刚性”参数污染的APV需要革兰氏阴性菌群,推测肠道起源具有最大的统计学意义
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Infiuence of parameters of artificial pulmonary ventilation and microaspiration of gastric contents on the frequency of development of neonatal pneumonia
One of the most frequent infectious diseases in nosological structure of the neonatal period is pneumonia. The newborns who are on the artificial pulmonary ventilation (APV) get into risk group on development the ventilator-associated pneumonia (VAP) which frequency increases in process of increase in duration of APV. It is established, that newborns, being on APV in most cases have a microaspiration of gastric contents that does relevant the purpose of the real research: studying of influence of APV and a microaspiration of gastric contents on the frequency of development and feature of a course of neonatal pneumonia. Materials and methods. The research included 177 newborns receiving respiratory therapy. The ex-pressiveness of a microaspiration was estimated on the basis of definition of Pepsinum in a tracheobron-chial aspirate (TBA). The diagnosis of VAP was established on the basis of reference clinical and radio-logical criteria. Main results of a research. It is established that the newborns who are on the APV with "rigid" parameters had more frequent cases of pneumonia with the expressed microaspiration of gastric contents. Patients with a combination of a microaspiration and pneumonia had the maximal duration the APV and the subsequent kislorodoterapiya. In a genesis of heavy respiratory frustration in the neonatal period with requirement in the APV with "rigid" parameters contamination of respiratory tracts a Gram-negative microflora, presumably intestinal origin had the greatest statistical
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