儿童无创通气的发展历程及其局限性  

The development process and limitations of non-invasive ventilation in children

作　　者：符跃强[1] 刘成军[1] Fu Yueqiang;Liu Chengjun(Department of Critical Care Medicine,Children's Hospital,Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院重症医学科、国家儿童健康与疾病临床医学研究中心、儿童发育疾病研究教育部重点实验室、儿童代谢与炎症性疾病重庆市重点实验室,400014

出　　处：《中国小儿急救医学》2024年第6期412-415,共4页Chinese Pediatric Emergency Medicine

摘　　要：无创通气(NIV)的发展历程已近百年,折射了现代医学发展史。目前NIV在儿科有着广泛应用,是呼吸支持治疗的重要组成部分,也是治疗儿童急性呼吸衰竭的重要方法。但是NIV因其自身特点,存在应用的限制和禁忌证,无法替代有创机械通气。使用NIV前需仔细评估患儿病情。NIV在儿童急性呼吸窘迫综合征、免疫功能受损和气管插管拔管后治疗时存在失败可能,可导致不良预后。NIV疗效不佳、病情恶化时需迅速进行气管插管和有创机械通气治疗。应该加强医务人员对NIV使用的培训,有经验的团队和精细化管理是NIV安全和有效使用的重要保证。The development process of non-invasive ventilation(NIV)has been nearly a century,reflecting the history of modern medical development.At present,NIV is widely used in pediatrics,and which is an important component of respiratory support therapy,as well as an important method for treating acute respiratory failure in children.However,non-invasive ventilation,due to its own characteristics,has limitations and contraindications,and cannot replace invasive mechanical ventilation.Before using NIV,it is necessary to carefully evaluate the patient's condition.NIV may fail in the treatment of pediatric patients with acute respiratory distress syndrome,immune dysfunction and post-extubation with acute respiratory failure,leading to poor prognosis.When the efficacy of NIV is poor and the condition worsens,prompt tracheal intubation and invasive mechanical ventilation treatment should be performed.Medical personnel should strengthen their training on the use of NIV.Teams with experienced members and refined management are important guarantees for the safe and effective use of NIV.

关 键 词：无创通气 儿童 急性呼吸衰竭 儿童急性呼吸窘迫综合征 免疫受损 

分 类 号：R720.5[医药卫生—儿科]