鼻塞式持续气道正压通气在小儿重症肺炎治疗中的应用价值  

Application value of nasal continuous positive airway pressure in the treatment of severe pneumonia in children

作　　者：帅词睿 付道勇 时刚亮 SHUAI Cirui;FU Daoyong;SHI Gangiang(Department of Pediatrics,Yichun People's Hospital,Yichun,Jiangxi,336000,China)

机构地区：[1]宜春市人民医院儿一科,江西宜春336000

出　　处：《当代医学》2023年第2期123-126,共4页Contemporary Medicine

摘　　要：目的探讨鼻塞式持续气道正压通气对小儿重症肺炎患儿的血气指标及临床体征的影响。方法回顾性分析2019年6月至2020年6月本院收治的90例小儿重症肺炎患儿的临床资料,按照治疗方法不同分为对照组与观察组,每组45例。对照组采用常规鼻导管吸氧治疗,观察组采用鼻塞式持续气道正压通气治疗,比较两组治疗前后血气指标[动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、治疗后症状体征(呼吸困难消失时间、发绀消失时间、心率异常消失时间、肺部啰音消失时间)及住院时间。结果治疗前,两组PaO_(2)、SaO_(2)、PaCO_(2)比较差异无统计学意义;治疗后,观察组PaO_(2)[(83.12±6.86)mmHg]、SaO_(2)[(96.07±2.33)%]均高于对照组[70.02±4.56)mmHg、(82.78±4.52)%],PaCO_(2)[(40.24±1.93)mmHg]低于对照组[(48.06±3.54)mmHg],差异有统计学意义(P<0.05)。观察组呼吸困难消失时间、发绀消失时间、心率异常消失时间、肺部啰音消失时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论鼻塞式持续气道正压通气治疗小儿重症肺炎疗效显著,可明显改善患儿血气指标和临床状况体征,缩短住院时间,值得临床推广应用。Objective To investigate the effect of nasal continuous positive airway pressure on blood gas indexes and clinical signs in children with severe pneumonia.Methods The clinical data of 90 children with severe pneumonia admitted to our hospital from June 2019 to June 2020 were retrospectively analyzed and they were divided into control group and observation group according to different treatment methods,with 45 cases in each group.The control group was treated with conventional nasal catheter oxygen inhalation,and the observation group was treated with nasal continuous positive airway pressure ventilation,the blood gas indexes(arterial partial pressure of oxygen[PaO_(2)],arterial oxygen saturation[SaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)])before and after treatment,symptoms and signs after treatment(dyspnea disappearance time,cyanosis disappearance time,heart rate abnormality disappearance time,lung rale disappearance time)and hospitalization time were compared between the two groups.Results Before treatment,there was no significant difference in PaO_(2),SaO_(2) and PaCO_(2) between the two groups;after treatment,the PaO_(2)([83.12±6.86]mmHg)and SaO_(2)([96.07±2.33]%)in the observation group were higher than those in the control group([70.02±4.56]mmHg,[82.78±4.52]%),the PaCO_(2)([40.24±1.93]mmHg)was lower than that of control group([48.06±3.54]mmHg),and the differences were statistically significant(P<0.05).The absence time of dyspnea,cyanosis,abnormal heart rate,pulmonary rales and hospitalization time in the observation group were all shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Nasal continuous positive airway pressure with nasal congestion has significant effect in the treatment of severe pneumonia in children,which can significantly improve blood gas indexes and clinical signs,shorten the hospitalization time,and is worthy of clinical promotion and application.

关 键 词：小儿重症肺炎 鼻塞式持续气道正压通气 血气指标 

分 类 号：R725.6[医药卫生—儿科]