免疫球蛋白辅助高流量鼻导管湿化氧疗对重症肺炎患儿血气分析指标和免疫球蛋白水平的影响  

Effect of Immunoglobulin Assisted Humidified High Flow Nasal Cannula on Blood Gas Analysis Indexes and Immunoglobulin Levels in Children with Severe Pneumonia

作　　者：李君娥[1] 徐梅先[1] 刘刚 孙慧[1] 郭艳梅[1] 石晓娜[1] 胡丽红[1] 赵欣[1] LI Jun-e;XU Mei-xian;LIU Gang;SUN Hui;GUO Yan-mei;SHI Xiao-na;HU Li-hong;ZHAO Xin(Department of Critical Care Medicine,Children's Hospital of Hebei Province,Shijiazhuang,Hebei,050031,China)

机构地区：[1]河北省儿童医院重症医学一科,河北石家庄050031

出　　处：《现代生物医学进展》2020年第17期3296-3300,共5页Progress in Modern Biomedicine

基　　金：河北省医学科学研究重点计划项目(20170384)。

摘　　要：目的:探讨免疫球蛋白辅助高流量鼻导管湿化氧疗(HHFNC)对重症肺炎患儿血气分析指标和免疫球蛋白水平的影响。方法:选取2017年6月到2018年9月期间在河北省儿童医院接受治疗的重症肺炎患儿93例,根据治疗方式的不同将93例重症肺炎患儿分为A组、B组和C组,A组给予经鼻持续气道正压通气(NCPAP),B组给予HHFNC,C组给予免疫球蛋白辅助HHFNC。比较三组患儿的临床疗效、血气分析指标、免疫球蛋白、临床症状改善情况、住院情况和并发症情况。结果:三组患儿的临床疗效整体比较差异无统计学意义(P>0.05);通气后24 h,C组和B组患儿的二氧化碳分压(PaCO2)水平低于A组(P<0.05);C组患儿的发绀消失时间、肺部哕音消失时间短于B组和A组(P<0.05),治疗7 d后,C组患儿的免疫球蛋白G(Ig G)水平高于B组和A组(P<0.05),C组和B组患儿的鼻损伤发生率均低于A组(P<0.05)。结论:与NCPAP相比,HHFNC可更有效地改善重症肺炎患儿二氧化碳潴留的现象,且可降低鼻损伤的发生率,联用免疫球蛋白可有效改善患儿的体液免疫功能,促进患儿的康复。Objective: To investigate the effects of immunoglobulin assisted humidified high flow nasal cannula(HHFNC) on blood gas analysis indexes and immunoglobulin levels in children with severe pneumonia. Methods: 93 children with severe pneumonia who were treated in Children’s Hospital of Hebei Province from June 2017 to September 2018 were enrolled. According to different treatment methods, 93 children with severe pneumonia were divided into group A, group B and group C. Group A was given nasal continuous positive airway pressure(NCPAP), group B was given HHFNC, and group C was given immunoglobulin assisted HHFNC.The clinical efficacy, blood gas analysis indexes, immunoglobulin, clinical symptoms, hospitalization and complications were compared between the three groups. Results: There were no significant differences in the clinical efficacy between the three groups(P>0.05). The level of partial pressure of carbon dioxide in artery(PaCO2) in group C and group B was lower than that in group A at 24 hours after ventilation(P<0.05). The cyanosis disappearance time and the disappearance time of pulmonary beep in the group C were shorter than those in the group B and the group A(P<0.05). After 7 days of treatment, the immunoglobulin G(Ig G) level of children in group C was higher than that in group B and group A(P<0.05). The incidence of nasal injury in group C and group B was lower than that in group A(P<0.05). Conclusion: Compared with NCPAP, HHFNC can more effectively improve the carbon dioxide retention in children with severe pneumonia, and can reduce the incidence of nasal injury, combined with immunoglobulin can effectively improve the humoral immune function of children and promote the rehabilitation of children.

关 键 词：重症 肺炎 免疫球蛋白 患儿 高流量鼻导管湿化氧疗 疗效 

分 类 号：R563.1[医药卫生—呼吸系统]