河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (11): 1282-1285,1290.doi: 10.3969/j.issn.1007-3205.2022.11.009

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加温湿化高流量鼻导管通气治疗婴幼儿重症肺炎的临床应用研究

  

  1. 广东医科大学附属深圳市龙华区中心医院儿科,广东 深圳 518110

  • 出版日期:2022-11-25 发布日期:2022-12-28
  • 作者简介:贾系群(1970-),女,河北邯郸人,广东医科大学附属深圳市龙华区中心医院主任医师,医学硕士,从事儿科疾病诊治研究。
  • 基金资助:
    深圳市龙华区卫生健康局项目(2020039)

Clinical application of heated humidified high flow nasal cannula ventilation in the treatment of severe pneumonia in infants

  1. Department of Pediatrics, the Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Guangdong Province, Shenzhen 518110, China

  • Online:2022-11-25 Published:2022-12-28

摘要: 目的 探讨加温湿化高流量鼻导管通气(heated humidified high flow nasal cannula ventilation,HHFNC)治疗婴幼儿重症肺炎的临床效果。
方法 选择我院诊断为重症肺炎患儿80例作为研究对象,采用随机数字表法分为面罩吸氧组(对照组)和HHFNC组(试验组)各40例,比较两组患儿治疗前与治疗后2 h、24 h、48 h动脉血氧分压(partial pressure oxygen,PaO2)、动脉血二氧化碳分压(partial pressure of carbondioxide,PCO2)、PaO2/吸入氧浓度(fraction of inspiration O2,FiO2)指标变化以及两组患儿呼吸困难(鼻扇及三凹征)缓解时间、住院时间及气管插管率。
结果 治疗前,两组患儿的PaO2、PCO2、PaO2/FiO2分别比较,差异无统计学意义(P>0.05),治疗后,PaO2、PaO2/FiO2呈逐渐升高趋势,PCO2呈逐渐降低趋势,试验组PaO2、PaO2/FiO2高于对照组,PCO2低于对照组,其组间、时点间及组间·时点间交互作用差异均有统计学意义(P<0.05),HHFNC组呼吸困难缓解时间及住院时间明显短于对照组,气管插管率明显低于对照组,差异均有统计学意义(P<0.05)。
结论 HHFNC治疗婴幼儿重症肺炎可以改善病情、缩短住院时间并减少气管插管率,效果显著。


关键词: 肺炎, 持续气道正压通气, 婴幼儿

Abstract: Objective To investigate the clinical effect of heated humidified high flow nasal cannula ventilation(HHFNC) in the treatment of severe pneumonia in infants. 
Methods A total of 80 children with severe pneumonia admitted to our hospital were selected as the research subjects and randomly divided into mask oxygen inhalation group(control group, n=40) and HHFNC group(experimental group, n=40) by random number table method. The changes in partial pressure oxygen(PaO2), partial pressure of carbon dioxide(PCO2), and PaO2/fraction of inspiration O2(FiO2) of the two groups were compared before treatment and at 2 h, 24 h, and 48 h after treatment. The relief time of dyspnea(nasal flaring and three-concave sign),the length of hospitalization and the rate of endotracheal intubation were compared.
Results Before treatment, PaO2, PCO2, PaO2/ FiO2 of the two groups were compared, and the differences was not statistically significant(P>0.05). After treatment,PaO2 and PaO2/FiO2 in two groups increased gradually,while PCO2 decreased gradually; PaO2 and PaO2/FiO2 in HHFNC group were higher than those in control group,while PCO2 was lower than those in control group; there were significant differences in the interaction among groups,time points and time points between groups(P<0.05). The relief time of dyspnea and the length of hospitalization were shorter, the rate of endotracheal intubation was lower in HHFNC group than in the control group, and the differences were statistically significant(P<0.05). 
Conclusion HHFNC in the treatment of severe pneumonia in infants can improve the condition, shorten the length of hospitalization, and reduce the rate of tracheal intubation, and the effect is significant.


Key words: pneumonia , continuous positive airway pressure, infants