肺炎支原体肺炎患儿支气管镜肺泡灌洗术中经鼻高流量氧疗的应用  

Application of high flow nasal cannula oxygen therapy during bronchoalveolar lavage in children with refractory mycoplasma pneumoniae pneumonia

作　　者：唐龙 钮明杨 贾理博 李文斌 杨佳 房莉 Tang Long;Niu Mingyang;Jia Libo;Li Wenbin;Yang Jia;Fang Li(Department of Respiratory Diseases,Xuzhou Children′s Hospital,Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学附属徐州儿童医院呼吸内科,江苏徐州221006 [2]徐州医科大学附属徐州儿童医院重症医学科,江苏徐州221006

出　　处：《护理学杂志》2024年第24期11-14,共4页Journal of Nursing Science

基　　金：徐州市卫生健康委医学科技创新项目(XWKYHT20230008);徐州市儿童医院科研项目(22040409)。

摘　　要：目的探讨经鼻高流量氧疗在难治性肺炎支原体肺炎患儿行支气管镜肺泡灌洗术中的应用效果,为儿童支气管镜检查选择合适的氧疗方式提供参考。方法选择行支气管镜肺泡灌洗术的86例难治性肺炎支原体肺炎患儿作为研究对象,按照医嘱的时间顺序分为经鼻高流量氧疗组和常规组各43例。行支气管镜肺泡灌洗术中经鼻高流量氧疗组给予经鼻高流量吸氧,氧流量为20~50 L/min,氧浓度为40%;常规组给予双鼻导管吸氧,氧流量为4 L/min。观察两组氧疗效果及不良反应发生情况。结果两组均顺利完成检查。经鼻高流量氧疗组术中低氧血症发生率、持续时间显著低于和短于常规组(均P<0.05);不同时间点的最低经皮血氧饱和度、术中呼吸频率最高值比较,差异有统计学意义(均P<0.05)。两组术中心率最高值、支气管镜检查用时、因缺氧致检查中断率及术中不良事件发生率比较,差异无统计学意义(均P>0.05)。结论经鼻高流量氧疗有助于难治性肺炎支原体肺炎患儿支气管镜肺泡灌洗术的顺利进行,降低低氧血症发生率,安全性能好。Objective To explore the effects applying high flow nasal cannula(HFNC)oxygen therapy during bronchoalveolar lavage in children with refractory Mycoplasma pneumoniae pneumonia(MMP),and to provide providing a reference for selecting appropriate oxygen therapy during pediatric bronchoscopy.Methods A total of 86 children with refractory MMP scheduled for bronchoalveolar lavage were selected as research subjects and assigned to the HFNC group and the conventional group according the sequence of medical order with 43 cases in each.During the procedure,the HFNC group received HFNC oxygen therapy with a flow rate of 20-50 L/min and an oxygen concentration of 40%,while the conventional group received oxygen via nasal cannula at a flow rate of 4 L/min.The oxygen therapy effects and occurrence of adverse reactions were observed in both groups.Results Both groups successfully completed the examination.The incidence rate and duration of intraoperative hypoxemia in the HFNC group were significantly lower than those in the conventional group(both P<0.05).Comparisons of the lowest transcutaneous oxygen saturation and maximum respiratory rate at different time points showed statistically significant differences(both P<0.05).There were no significant differences between the two groups in terms of maximum heart rate,time taken for bronchoscopy,interruption rates due to hypoxia,and occurrence of intraoperative adverse events(all P>0.05).Conclusion HFNC oxygen therapy facilitates the smooth performance of bronchoalveolar lavage in children with refractory MMP,reduces the incidence of hypoxemia,and has good safety performance.

关 键 词：患儿 支原体肺炎 支气管肺泡灌洗 氧疗 经鼻高流量氧疗 鼻导管吸氧 低氧血症 插管护理 

分 类 号：R473.72[医药卫生—护理学]