经鼻持续气道正压通气治疗婴幼儿重症肺炎合并呼吸衰竭的临床研究  

Clinical research of Nasal continuous positive airway pressure (NCPAP) in the treatment of infantile severe pneumonia complicated with respiratory failure

作　　者：黄燕[1] 朱紫微 郭军[1] Huang Yan;Zhu Ziwei;Guo Jun(Breath Internal Medicine Department,Dalian Children's Hospital Affiliated to Dalian Medical University,Dalian,Liaoning,116000,China)

机构地区：[1]大连医科大学附属儿童医院呼吸内科,辽宁大连116000

出　　处：《当代医学》2018年第11期42-45,共4页Contemporary Medicine

基　　金：重大疾病的防控策略;诊疗规范及效果评价研究(2015BAI12B00);全国多中心儿童慢性呼吸功能不全的无创通气治疗研究(2015BAI12B09)

摘　　要：目的探索经鼻持续气道正压通气在治疗婴幼儿重症肺炎合并呼吸衰竭的应用价值。方法选取婴幼儿重症肺炎合并呼吸衰竭70例,随机分为治疗组和对照组分别35例,入选患儿均给予抗感染、必要时抗炎、纠正酸碱失衡、止咳等常规治疗。治疗组在常规治疗基础上给予经鼻持续气道正压通气治疗(NCPAP),比较两组患儿动脉血气数值和临床指标变化。结果两组患儿经过治疗后24 h、48 h动脉血pH、PaO_2、Pa CO_2均较治疗前好转,差异具有统计学意义(P<0.05);治疗组和对照组相比,治疗24 h及48 h后PaO_2明显升高,差异具有统计学意义(P<0.05);与对照组相比,治疗组患儿的气促持续时间、住院天数、总病程均缩短,差异有统计学意义(P<0.05)。结论婴幼儿重症肺炎合并呼吸衰竭在常规治疗的基础上,同时加用经鼻持续正压通气治疗可快速纠正低氧血症,缓解临床症状,缩短住院时间及总病程,提高疗效,值得临床应用。Objective To investigate the clinical value of nasal continuous positive airway pressure in the treatment of severe pneumonia associated with respiratory failure in infants.Methods 70 cases of severe pneumonia in infants with respiratory failure were selected and randomly divided into treatment group and control group,there are 35 cases in each group,all patients were given thetreatment of anti-infection,anti-inflammation,correcting acid-base imbalance and other conventional treatment.The treatment group was treated with nasal continuous positive airway pressure(NCPAP)on the basis of routine treatment,and the arterial blood gas indexes and clinical indexes of the two groups were compared.Results After treatment for 24 hours,48 hours,arterial blood pH,PaO2 and PaCO2 of two groups’of patients were better than those before the treatment,the difference was statistically significant(P<0.05);the treatment group compared with control group,PaO2 increased significantly after the treatment of 24 h and 48 hours,significant difference(P<0.05);compared with the control group,treatment group has the shorted time of anhelation duration days,hospitalization days,course of disease,the difference was statistically significant(P<0.05).Conclusion Severe pneumonia in infants with respiratory failure on the basis of conventional therapy combined with nasal continuous positive airway pressure therapy can quickly correct hypoxemia,relieve clinical symptoms,shorten the hospitalization time and the illness course,improve the linical effect,worthy of clinical application.

关 键 词：CPAP 婴幼儿 重症肺炎 呼吸衰竭 

分 类 号：R725.6[医药卫生—儿科]