持续正压通气治疗婴儿重症毛细支气管炎30例临床分析  

Continuous positive airway pressure for infants with severe bronchiolitis: clinical analysis of 30 cases

作　　者：周勇[1] 郑伟华[1] 张红[1] 王昕[1] 彭娟[1] 

机构地区：[1]桂林医学院附属医院儿科,广西桂林541001

出　　处：《广州医学院学报》2013年第3期71-73,共3页Academic Journal of Guangzhou Medical College

基　　金：广西壮族自治区教育厅科研项目(桂教科研[2012]10号;桂教科研[2008]27号);广西壮族自治区卫生厅科研项目(桂卫科教[2008]25号)

摘　　要：目的:探讨无创呼吸机持续正压通气(CPAP)治疗重症毛细支气管患儿的疗效。方法:回顾性分析2012年3月至2013年3月桂林医学院附属医院儿科收治的接受无创呼吸机治疗的重症毛细支气管炎患儿30例的临床资料,记录患儿CPAP使用时间、住院时间、并发症发生情况及治疗结果,比较CPAP治疗前及撤机前患儿血气分析变化。结果:30例患儿CPAP使用时间(90.8±32.9)h,平均住院时间(7.6±3.3)d。经CPAP治疗后均成功撤机,无并发症发生,无气管插管病例和死亡病例。血气分析显示,与治疗前比较,CPAP治疗后患儿血pH值和PaO_2升高[7.47±0.09比7.20±0.30,(90.32±40.36)mmHg比(78.65±8.92)mmHg,(1mmHg=0.133 kPa),均P<0.01],PaCO_2和PaO_2/FiO_2降低[(47.95±6.89)mmHg比(68.60±5.03)mmHg,324.58±3.62比256.49±69.37,均P<0.01]。结论:CPAP治疗婴儿重症毛细支气管炎疗效较好。Objective：To assess the efficacy of continuous positive airway pressure（ CPAP） for treatment in infants with severe broncbiulitis. Methods ： We did a retrospective analysis on the clinical profiles of 30 infants with severe bronchiolitis who were treated with CPAP in the department of pediatrics,Affiliated Hospital of Guilin Medical University,between March 2012 and March 2012. This entailed recording of the duration of use of CPAP, length of hospital stay, incidence of complications and therapeutic outcomes, thus allowing for comparison on the changes in blood-gas analysis prior to and following weaning. Results ： The duration of use was （ 90.8 ± 32.9 ） h and average length of hospital stay was （ 7.6 ± 3.3 ） days. No complication was documented following successful weaning. No case required tracheotomy or succumbed. Blood-gas analysis showed that, compared with pretreatment levels, CPAP yielded an increased level of PH[ （7.47 ±0.0） vs （7.20 ± 0. 30 ） , P 〈 0.01 ） and PaO2 [ （ 90.32± 40.36 ） mmHg vs （ 78.65 ± 8.92 ） mmHg, P 〈 0. 05 ] yet reduced PaCO： [ （ 47.95±6.89 ） mmHg vs （68.60 ±5.03） mmHg,P 〈 0. 01 ] and PaO：/FiO2 [ （324.58 ± 3.62） vs （256. 49 ±69. 37） ,P 〈 0. 01 ]. Conclusion： CPAP is an effective treatment for infants with severe bronehiolitis.

关 键 词：毛细支气管炎 婴儿 连续气道正压通气 

分 类 号：R725.6[医药卫生—儿科]