小潮气量通气治疗儿童呼吸道合胞病毒并发肺炎呼吸衰竭(附76例报道)  

Low-tidal Volume Ventilation for Respiratory Syncytial Virus Infected Children with Pneumonia and Respiratory Failure and Seventy-six Cases's Report

作　　者：顾凤珍[1] 杜晓晨[1] 谢敏慧[1] 

机构地区：[1]苏州大学附属儿童医院急救科,江苏苏州215003

出　　处：《苏州大学学报（医学版）》2011年第5期802-805,共4页Suzhou University Journal of Medical Science

摘　　要：目的探讨小潮气量通气治疗儿童呼吸道合胞病毒并发肺炎呼吸衰竭的临床疗效及肺保护作用。方法选取儿童重症监护室2002年1月至2010年2月收治的小儿呼吸道合胞病毒并发肺炎呼吸衰竭需要机械通气治疗患儿。2002年1月至2005年1月采用大潮气量通气策略,共53例患儿(大潮气量组);2005年2月至2010年2月采用小潮气量通气策略,共76例患儿(小潮气量组)。观察两组之间呼吸机参数、机械通气并发症及预后等指标。比较小潮气量组机械通气前、通气后6～8 h和通气后24 h的血气分析。结果小潮气量通气组的气漏发生率显著低于大潮气量通气组;小潮气量机械通气能明显改善低氧血症和二氧化碳潴留,同时避免过度通气。结论呼吸道合胞病毒并发肺炎呼吸衰竭患儿机械通气策略适宜于小潮气量,它能够降低气压伤发生。Objective To explore clinical effect of low-tidal volume ventilation and lung-protective effect on respiratory syncytial virus（RSV） infected children with pneumonia and respiratory failure.Methods Selected RSV-infected children with pneumonia and respiratory failure in pediatric intensive care unit（PICU） from 2002 January to 2010 February who need ventilation.The ventilation strategy from 2002 January to 2005 January was large–tidal volume,it recruited 53 cases;the ventilation strategy from 2005 February to 2010 February was low-tidal volume,it recruited 76 cases.The parameters of ventilator、the complication and prognosis were observed between the two groups.The change between blood-gas before ventilation、6-8 hours after ventilation and 24 hours after ventilation in low-tidal volume group were compared.Results The incidence of barotrauma in low-tidal volume ventilation group was significantly lower than that in large tidal volume ventilation group;low-tidal volume ventilation improved hypoxemia and carbon dioxide retention and hyperventilation avoided at the same time.Conclusions The low-tidal volume ventilation strategy is suitable for respiratory syncytial virus-infected children with pneumonia and respiratory failure,it can reduce the incidence of barotraumas.

关 键 词：呼吸道合胞病毒 重症肺炎 呼吸衰竭 机械通气 小潮气量 

分 类 号：R725.6[医药卫生—儿科]