早期CPAP对小儿重症肺炎并呼吸衰竭血气指标及预后的影响  

Effect of CPAP on blood gas and prognosis of infants with severe pneumonia complicated with respiratory failure at early stage

作　　者：王玉瑛[1] 韩波[1] 高怡玢[2] 焦爱萍[1] 汤淑斌[1] 黎建丽[1] 

机构地区：[1]宝鸡市妇幼保健院儿二科,陕西宝鸡721000 [2]宝鸡市妇幼保健院儿科实验室,陕西宝鸡721000

出　　处：《临床肺科杂志》2016年第1期75-78,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析小儿重症肺炎并呼吸衰竭行早期持续气道正压通气(CPAP)血气指标及预后影响。方法采用临床对照研究回顾性分析72例重症肺炎合并呼吸衰竭患儿临床资料,随机分为两组采用不同治疗方案,每组各36例。行常规方案治疗者设为对照组,行早期持续气道正压通气治疗者设观察组,比较两组疗效、血气与预后情况。结果观察组肺部啰音、发绀、呼吸困难消失时间明显短于对照组,心率恢复正常与住院时间短于对照组(P<0.05)。两组Sa O2、Pa CO2、Pa O2及p H等,治疗后均有一定改善,观察组改善程度更明显,组间、组内对比均有统计学意义(P<0.05,P<0.01);观察组病死率低于对照组(P<0.05)。结论小儿重症肺炎并呼吸衰竭行早期CPAP可改善病情及预后。Objective To analyze the effect of continuous positive airway pressure（ CPAP） on blood gas and prognosis of infants with severe pneumonia complicated with respiratory failure at early stage. Methods The clinical data of 72 children with severe pneumonia complicated with respiratory failure were retrospectively analyzed.They were randomly divided into two groups,and each group were treated with different therapeutic schedule. The control group was given conventional treatment,and the observation group was given continuous positive airway pressure at the early stage. The effect,blood gas and prognosis in the two groups were compared. Results The time for the disappearance of pulmonary rales,cyanosis and breathing difficulties in the observation group was significantly shorter than those in the control group,so was the time for heart rate back to normal and hospital stay（ P 〈0. 05）.After the treatment,the level of Pa O2,Pa CO2,Pa O2 and p H improved in the two groups,and the improvement was more pronounced in the observation group than in the control group（ P 〈0. 05,P 〈0. 01）. Besides,the mortality was lower in the observation group than in the control group（ P 〈0. 05）. Conclusion CPAP can improve the patients＇ condition and prognosis in children with severe pneumonia complicated with respiratory failure at early stage.

关 键 词：重症肺炎 呼吸衰竭 持续气道正压通气 小儿 

分 类 号：R725.6[医药卫生—儿科]