经鼻持续气道正压通气在重症肺炎伴呼吸衰竭患儿中的应用效果  

Effect of nasal continuous positive airway pressure ventilation on severe pneumonia complicated by respiratory failure in children

作　　者：孔丹[1] 陈娜[1] Kong Dan;Chen Na(Department of Emergency,Children's Hospital Afiliated of Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院急诊科,郑州450052

出　　处：《中国实用医刊》2023年第19期59-62,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析经鼻持续气道正压通气在重症肺炎伴呼吸衰竭患儿中的应用效果。方法抽取2021年3月至2023年3月郑州大学附属儿童医院收治的重症肺炎伴呼吸衰竭患儿92例,根据治疗措施分为两组。给予鼻导管常规吸氧的43例患儿纳入对照组,予以经鼻持续气道正压通气的49例患儿纳入观察组。比较两组临床疗效、症状改善情况、动脉血气分析指标及肺功能。结果观察组治疗总有效率(93.88%,46/49)高于对照组(79.07%,34/43),心率恢复正常时间、呼吸困难缓解时间、肺部啰音消失时间[(1.52±0.36)、(1.79±0.21)、(2.02±0.46)]短于对照组[(2.31±0.57)、(3.46±0.68)、(3.95±0.75)d],差异有统计学差异(P<0.05);治疗前,两组动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、用力肺活量(FVC)、呼气流量峰值(PEF)、第1秒用力呼气量(FEV1)比较差异未见统计学意义(P>0.05);治疗后,观察组PaCO_(2)[(44.29±2.57)mmHg,1 mmHg=0.133 kPa]低于对照组[(50.34±3.21)mmHg],PaO_(2)、SaO_(2)、FVC、PEF、FEV1[(69.28±8.21)mmHg、(93.68±8.21)%、(3.34±0.78)L、(3.58±0.83)L/s、(1.98±0.37)L]高于对照组[(58.74±6.38)mmHg、(81.59±6.47)%、(2.28±0.69)L、(2.79±0.78)L/s、(1.49±0.26)L],差异有统计学意义(P<0.05)。结论经鼻持续气道正压通气在重症肺炎伴呼吸衰竭患儿的治疗中效果较好,可减轻患儿症状,调节动脉血气分析指标,改善肺功能。Objective To analyze the effect of nasal continuous positive airway pressure ventilation in the treatment of children with severe pneumonia complicated by respiratory failure.Methods A total of 92 children with severe pneumonia complicated by respiratory failure admitted to Children’s Hospital Affiliated of Zhengzhou University from March 2021 to March 2023 were seleccted.And they were divided into two groups according to treatment protocol.Forty-three children who received routine oxygen inhalation through nasal catheters were included in the control group,while 49 children who received nasal continuous positive airway pressure ventilation were included in the observation group.The clinical efficacy,symptom improvement,arterial blood gas analysis indexes,and lung function were compared between the two groups.Results The total effective rate of the observation group(93.88%,46/49)was higher than that of the control group(79.07%,34/43),P<0.05.The time of heart rate returning to normal was(1.52±0.36)days,the time of dyspnoea relieving was(1.79±0.21)days,and the time of lung rale disappearance was(2.02±0.46)days in the observation group;the three indicators in the observation group were shorter than the(2.31±0.57)days,(3.46±0.68)days,and(3.95±0.75)days in the control group,correspondingly(P<0.05).Before treatment,there was no significant difference between the two groups in arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2)),forced vital capacity(FVC),peak expiratory flow(PEF),and forced expiratory volume in 1 second(FEV1),P>0.05.After treatment,the PaCO_(2)in the observation group was(44.29±2.57)mmHg(1 mmHg=0.133 kPa),lower than the(50.34±3.21)mmHg in the control group(P<0.05),while PaO_(2),SaO_(2),FVC,PEF and FEV1 in the observation group were(69.28±8.21)mmHg,(93.68±8.21)%,(3.34±0.78)L,(3.58±0.83)L/s,and(1.98±0.37)L,respectively,higher than the(58.74±6.38)mmHg,(81.59±6.47)%,(2.28±0.69)L,(2.79±0.78)L/s and(1.49±0.2

关 键 词：肺炎 重症 呼吸衰竭 经鼻持续气道正压通气 

分 类 号：R725.6[医药卫生—儿科]