早期鼻塞式持续气道正压通气在重症肺炎并发呼吸衰竭患儿中的应用效果  

Effect of early nasal continuous positive airway pressure on children with severe pneumonia complicated by respiratory failure

作　　者：张衡[1] 陈娜[1] Zhang Heng;Chen Na(Department of Emergency,Children’s Hospital 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21期55-58,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨早期鼻塞式持续气道正压通气(CPAP)在重症肺炎并发呼吸衰竭患儿中的应用效果。方法回顾性分析2020年6月至2021年7月郑州大学附属儿童医院收治的92例重症肺炎并发呼吸衰竭患儿的临床资料,按照治疗方法分为对照组与观察组,每组46例。两组均行常规治疗,对照组予以鼻导管吸氧治疗,观察组予以早期鼻塞式CPAP治疗,两组均观察至患儿出院。对比两组血气分析指标水平、临床症状缓解时间、临床疗效、不良反应发生情况及住院时间。结果治疗后,观察组动脉血氧饱和度、动脉血氧分压、pH值分别为(91.96±9.12)%、(70.66±7.03)mmHg(1 mmHg=0.133 kPa)、7.31±0.13,高于对照组的(84.86±8.19)%、(61.66±6.93)mmHg、7.20±0.18(P<0.05)。治疗后,观察组动脉血二氧化碳分压、氧浓度分数[(47.51±8.96)mmHg、0.40±0.05]低于对照组[(55.96±10.02)mmHg、0.45±0.06],P<0.05;观察组心率恢复正常、呼吸困难缓解、肺部啰音消失及发绀消失时间分别为(34.31±5.22)、(26.29±5.34)、(4.22±0.98)、(26.29±6.92)h,均短于对照组的(45.46±6.98)、(38.32±6.12)、(6.44±1.23)、(34.36±8.11)h,差异有统计学意义(P<0.05);观察组临床总有效率(95.65%,44/46)高于对照组(82.61%,38/46),P<0.05;两组不良反应发生率比较差异未见统计学意义(P>0.05);观察组住院时间[(16.22±1.48)d]短于对照组[(11.12±1.02)d],P<0.05。结论早期鼻塞式CPAP治疗重症肺炎并发呼吸衰竭患儿具有较好的治疗效果,利于改善其血气分析情况,加快病情恢复,缩短住院时间,且不会增加不良反应的发生,具有较好的应用安全性。Objective To investigate the curative effect of early nasal continuous positive airway pressure(CPAP)on severe pneumonia complicated by respiratory failure in children.Methods The clinical data of 92 children with severe pneumonia complicated by respiratory failure admitted to Children’s Hospital of Zhengzhou University from June 2020 to July 2021 were retrospectively analyzed.According to the treatment method,they were divided into the control group and the observation group,with 46 cases in each group.Both groups received routine treatment.The control group received nasal catheter oxygen therapy,while the observation group received early nasal CPAP treatment.Both groups were observed until the patient was discharged.The levels of blood gas analysis indicators,clinical symptom relief time,clinical efficacy,incidence of adverse reactions and hospital stay were compared between the two groups.Results After treatment,the arterial oxygen saturation,arterial partial pressure of oxygen,and pH value in the observation group were(91.96±9.12)%,(70.66±7.03)mmHg(1 mmHg=0.133 kPa),and 7.31±0.13,respectively,all of which were higher than the(84.86±8.19)%,(61.66±6.93)mmHg,and 7.20±0.18 in the control group,correspondingly(P<0.05).After treatment,the levels of arterial partial pressure of carbon dioxide and oxygen concentration fraction in the observation group were(47.51±8.96)mmHg and 0.40±0.05,respectively,which were lower than the(55.96±10.02)mmHg and 0.45±0.06 in the control group(P<0.05).The time of heart rate recovery,dyspnea alleviation time,lung rales disappearance time and cyanosis disappearance time in the observation group were(34.31±5.22)h,(26.29±5.34)h,(4.22±0.98)h,and(26.29±6.92)h,respectively,which were shorter than the(45.46±6.98)h,(38.32±6.12)h,(6.44±1.23)h,and(34.36±8.11)h in the control group,with statistically significant differences(P<0.05).The total clinical effective rate of the observation group(95.65%,44/46)was higher than that of the control group(82.61%,38/46),P<0.05.There was no

关 键 词：肺炎 呼吸衰竭 持续气道正压通气 血气分析 病情恢复 不良反应 

分 类 号：R725.6[医药卫生—儿科]