干预性呼吸治疗在婴幼儿先天性心脏病围手术期的应用  

Application of interventional respiratory therapy in peri-operative period of congenital heart disease in infants

作　　者：杨贵红[1] 田甫翠[1] 邓喜成[1] 李运飞[1] 罗天女[1] 刘剑[1] YANG Guihong;TIAN Fucui;DENG Xicheng;LI Yunfei;LUO Tiannü;LIU Jian(Thoracic Surgery of Children's Hospital of Hunan Province, Changsha 410007,China)

机构地区：[1]湖南省儿童医院心胸外科

出　　处：《中国中西医结合儿科学》2019年第3期254-257,共4页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的探讨干预性呼吸治疗改善先天性心脏病患儿术后呼吸功能的效果。方法选择2017年11月至2018年4月湖南省儿童医院收治的先心病患儿40例为研究对象,随机分为观察组与对照组各20例。分别给予常规呼吸治疗方法和干预性呼吸治疗方法,分别检测和比较两组患儿呼吸机辅助时间和心脏重症监护室停留时间、二次气管插管率、动脉血气分析指标,通气/血流比以及胸片结果。结果观察组患儿呼吸机辅助时间和心脏重症监护室滞留时间均显著短于对照组,差异有统计学意义(P<0.05)。观察组二次气管插管率为10.0%(2/20),显著低于对照组65.0%(13/20),差异有统计学意义(P<0.05)。观察组治疗后血PCO2和PO2均显著优于对照组,差异有统计学意义(P<0.05);两组血氧饱和度比较差异无统计学意义(P>0.05)。两组患儿治疗后通气/血流比值由治疗前的失调均得到明显平衡和改善。观察组并发症发生率为5.0%(1/20),显著低于对照组55.0%(11/20),差异有统计学意义(P<0.05)。结论干预性呼吸治疗能改善先天性心脏病患儿术后呼吸功能和肺通气,提高手术成功率。Objective To explore the effect of interventional respiratory therapy on postoperative respiratory function in infants with congenital heart disease. Methods Totally 40 children with congenital heart disease were randomly divided into control group( n =20) and observation group( n =20), who were hospitalized in Thoracic Surgery of Children's Hospital of Hunan Province from November 2017 to April 2018. The control group was treated with the routine respiratory therapy, and the observation group was treated with the interventional respiratory therapy. The auxiliary time of the ventilator, the time of staying in the CICU, the incidence rate of the secondary air tube, the blood gas analysis index, the ventilation/ blood flow ratio and the results of the chest film in both groups were compared. Results The auxiliary time of the ventilator and the time of staying in the CICU were significantly shorter in observation group than in control group( P <0.05). The incidence rate of the secondary air tube in observation group (10.0%, 2/20) was significantly lower than that in control group(65.0%, 13/20) and the difference was statistical significant( P <0.05). After treatment, the blood PCO 2 and PO 2 was significantly better in observation group than in control group( P <0.05). There was no significant difference in the blood oxygen saturation between the two groups( P >0.05). However, the incidence of complications in the observation group(5.0%, 1/20) were lower than that in the control group(55.0%, 11/20) and the difference was statistically significant( P < 0.05). In addition, the ventilation/blood flow ratio was significantly balanced and improved in both groups after treatment. Conclusion Interventional respiratory therapy can improve the postoperative respiratory function and lung ventilation in infants with congenital heart disease, and increase the success rate of operation.

关 键 词：先天性心脏病 呼吸治疗 肺部物理疗法 婴幼儿 

分 类 号：R541.1[医药卫生—心血管疾病]