加温湿化高流量鼻导管通气联合抗生素阶梯疗法对小儿重症肺炎血氧状态及炎性因子的影响  

Effects of heated humidified high-flow nasal cannula combined with antibiotic step therapy on blood oxygen status and inflammatory factors in children with severe pneumonia

作　　者：高萃[1] 党赫铭 高永伟 GAO Cui;DANG Heming;GAO Yongwei(Yan'an University Affiliated Hospital,Yan'an 716000,China)

机构地区：[1]延安大学附属医院,陕西延安716000

出　　处：《临床医学研究与实践》2022年第23期39-41,共3页Clinical Research and Practice

基　　金：延安大学附属医院科学技术研究发展计划项目(No.2021PT-11)。

摘　　要：目的研究加温湿化高流量鼻导管通气联合抗生素阶梯疗法对小儿重症肺炎血氧状态及炎性因子的影响。方法将本院收治的84例重症肺炎患儿根据治疗方法的不同分为对照组(常规机械通气联合常规抗生素)和观察组(加温湿化高流量鼻导管通气联合抗生素阶梯疗法),各42例。比较两组的治疗效果。结果治疗后,观察组的动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、肺动态顺应性(Cdyn)高于对照组,动脉二氧化碳分压(PaCO_(2))、呼吸机呼吸功(WOBv)低于对照组(P<0.05)。治疗后,两组的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平均低于治疗前,且观察组低于对照组(P<0.05)。观察组的体温恢复正常时间、机械通气时间、啰音消失时间、抗生素使用时间、感染控制时间及住院时间均短于对照组,治疗总有效率高于对照组(P<0.05)。两组的不良反应总发生率无显著差异(P>0.05)。结论加温湿化高流量鼻导管通气联合抗生素阶梯疗法应用在小儿重症肺炎治疗中的效果显著,可较好地改善临床症状及体征、血氧状态、炎性因子水平。Objective To study the effects of heated humidified high-flow nasal cannula combined with antibiotic step therapy on blood oxygen status and inflammatory factors in children with severe pneumonia.Methods A total of 84 children with severe pneumonia treated in our hospital were divided into control group(conventional mechanical ventilation combined with conventional antibiotic)and observation group(heated humidified high-flow nasal cannula combined with antibiotic step therapy)according to different treatment methods,with 42 cases in each group.The therapeutic effects of the two groups were compared.Results After treatment,arterial partial pressure of oxygen(PaO_(2)),arterial blood oxygen saturation(SaO_(2)) and dynamic compliance(Cdyn)in the observation group were higher than those in the control group,and arterial partial pressure of carbon dioxide(PaCO_(2)) and work of breathing of ventilator(WOBv)were lower than those in the control group(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)in the two groups were lower than those before treatment,and those in the observation group were lower than the control group(P<0.05).The time of body temperature returned to normal,mechanical ventilation time,rale disappearance time,antibiotic use time,infection control time and hospitalization time in the observation group were shorter than those in the control group,the total effective rate of treatment was higher than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The heated humidified high-flow nasal cannula combined with antibiotic step therapy in the treatment of severe pneumonia in children has a significant effect,which can better improve the clinical symptoms and signs,blood oxygen status and inflammatory factors levels.

关 键 词：小儿 重症肺炎 加温湿化高流量鼻导管通气 抗生素 

分 类 号：R725.6[医药卫生—儿科]