小潮气量机械通气和人免疫球蛋白联合治疗儿童重症肺炎疗效观察  

Clinical efficacy of low tidal volume mechanical ventilation combined with human immunoglobulin in the treatment of severe pneumonia in children

作　　者：王春雨 李亚 王家豪 WANG Chunyu;LI Ya;WANG Jiahao(Department of Pediatric Emergency,Zhumadian Central Hospital,Zhumadian 463000,Henan Province,China)

机构地区：[1]驻马店市中心医院急诊儿科,河南驻马店463000

出　　处：《新乡医学院学报》2024年第10期930-934,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨小潮气量机械通气联合人免疫球蛋白治疗儿童重症肺炎的临床疗效及对患儿肺功能、体液免疫功能的影响。方法选择2019年1月至2020年12月驻马店市中心医院收治的126例重症肺炎患儿为研究对象。根据治疗方法将患儿分为对照组(n=65)和观察组(n=61)。2组患儿均给予常规治疗,在此基础上,对照组患儿给予小潮气量机械通气治疗,观察组患儿给予小潮气量机械通气联合人免疫球蛋白治疗,2组患儿均连续治疗1周。比较2组患儿的临床疗效、治疗前后肺功能指标[第1秒用力呼气量(FEV_(1))、用力肺活量(FVC)、呼气流量峰值(PEF)]、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))]、体液免疫功能指标[免疫球蛋白(Ig)A、IgG、IgM]及不良反应发生情况。结果对照组和观察组患儿治疗总有效率分别为73.85%(48/65)、88.52%(54/61),观察组患儿总有效率显著高于对照组(P<0.05)。治疗前2组患儿FEV_(1)、FVC、PEF比较差异无统计学意义(P>0.05);2组患儿治疗后FEV_(1)、FVC、PEF均显著高于治疗前(P<0.05);治疗后,观察组患儿FEV_(1)、FVC、PEF均显著高于对照组(P<0.05)。治疗前2组患儿PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2)比较差异无统计学意义(P>0.05);2组患儿治疗后PaO_(2)、PaO_(2)/FiO_(2)显著高于治疗前,PaCO_(2)显著低于治疗前(P<0.05);治疗后,观察组患儿PaO_(2)、PaO_(2)/FiO_(2)显著高于对照组,PaCO_(2)显著低于对照组(P<0.05)。治疗前2组患儿IgA、IgG、IgM水平比较差异无统计学意义(P>0.05);2组患儿治疗后IgA、IgG、IgM水平显著低于治疗前(P<0.05);治疗后,观察组患儿IgA、IgG、IgM水平显著低于对照组(P<0.05)。对照组和观察组患儿不良反应发生率分别为18.46%(12/65)、32.79%(20/61),2组患儿不良反应发生率比较差异无统计学意义(χ^(2)=0.007,P>0.05)。结论相较于小潮气量机械通气治疗,小潮气量机械Objective To investigate the clinical efficacy of low tidal volume mechanical ventilation combined with human immunoglobulin in the treatment of severe pneumonia in children and the effects on lung function and humoral immune function.Methods A total of 126 children with severe pneumonia admitted to the Zhumadian Central Hospital from January 2019 to December 2020 were selected as the research subjects.According to the treatment method,the children were divided into a control group(n=65)and an observation group(n=61).All children in the two groups were given routine treatment.On this basis,children in the control group were given low tidal volume mechanical ventilation,while children in the observation group were given low tidal volume mechanical ventilation combined with human immunoglobulin.All children in the two groups were treated continuously for 1 week.The clinical efficacy,pulmonary function indexes[forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),and peak expiratory flow(PEF)]before and after treatment,blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),and oxygenation index(PaO_(2)/FiO_(2))],humoral immune function indexes[immunoglobulin(Ig)A,IgG,and IgM],and the occurrence of adverse reactions were compared between the two groups.Results The total effective rates of children in the control group and the observation group were 73.85%(48/65)and 88.52%(54/61),respectively,and the total effective rate of children in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in FEV_(1),FVC and PEF between the two groups before treatment(P>0.05).After treatment,FEV_(1),FVC and PEF of children in the two groups were significantly higher than those before treatment(P<0.05).After treatment,FEV_(1),FVC and PEF of children in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in Pa

关 键 词：重症肺炎 小潮气量机械通气 人免疫球蛋白 肺功能 体液免疫 儿童 

分 类 号：R725.6[医药卫生—儿科]