经鼻持续正压通气治疗中-重度毛细支气管炎的临床研究

doi:10.3969/j.issn.10073205.2019.09.004

河北医科大学学报

经鼻持续正压通气治疗中-重度毛细支气管炎的临床研究

河北医科大学附属河北省儿童医院急诊科，河北石家庄 050031

出版日期:2019-09-25 发布日期:2019-09-16
作者简介:贾系群（1970-），女，河北邯郸人，河北医科大学附属河北省儿童医院主任医师，医学硕士，从事儿科疾病诊治研究。
基金资助:
河北省科技计划项目（1727737D）

Clinical medical research of nasal continuous positive airway pressure in moderate to severe capillary bronchitis

Department of Emergency， Affiliated Hebei Children′s Hospital of Hebei Medical University, Shijiazhuang 050031, China

Online:2019-09-25 Published:2019-09-16

摘要/Abstract

摘要： ［摘要］
〖HTH〗目的〖HTSS〗〖KG*2〗探讨经鼻持续正压通气（nasal continuous positive airway pressure，nCPAP）治疗中-重度毛细支气管炎的有效性及安全性。
〖HTH〗方法〖HTSS〗〖KG*2〗前瞻性观察符合nCPAP使用标准的中-重度毛细支气管炎患儿120例，剔除数据不完整病例4例，最终纳入116例。根据临床转归分为治疗成功组和未成功组，于治疗前和治疗后2 h、24 h、48 h比较2组动脉血氧分压（partial pressure of oxygen，PaO2）、动脉血二氧化碳分压（partial pressure of carbon dioxide,PaCO2）、PaO2/吸入氧浓度（fraction of inspiration O2，FiO2）、呼吸频率、心率。
〖HTH〗结果〖HTSS〗〖KG*2〗nCPAP治疗成功组108例（93.1%）；未成功组8例（6.9%），均改为气管插管行有创机械通气。治疗前，未成功组PaO2、PaO2/FiO2明显低于成功组，PaCO2明显高于成功组（P＜0.05）。成功组治疗后呼吸频率、心率、PaCO2逐渐降低，PaO2、PaO2/FiO2逐渐升高（P＜0.05）。所有患儿对nCPAP耐受良好，无不良事件发生。
〖HTH〗结论〖HTSS〗〖KG*2〗应用nCPAP治疗中-重度毛细支气管炎效果显著，安全性高，能有效改善患儿氧合、缓解其高碳酸血症，但对于存在严重低氧血症、CO2潴留明显的患儿，需尽早选择有创通气。

关键词: 细支气管炎, 连续气道正压通气, 婴儿

Abstract: ［Abstract］Objective〖HTSS〗To investigate the safety and efficiency of nasal continuous positive airway pressure(nCPAP) in moderate to severe capillary bronchitis.
〖HTH〗〖WTHZ〗Methods〖HTSS〗This was a prospective study.Children who were admitted with moderate to severe capillary bronchitis and met the nCPAP ventilation indications.A total of 120 children were included,4 cases with incomplete data were excluded,and 116 cases were finally included.According to clinical outcomes,the two groups were divided into the successful group and the unsuccessful group.The differences in partial pressure of oxygen（PaO2）, partial pressure of carbon dioxide（PaCO2）, PaO2/fraction of inspiration O2（FiO2）, breath and heart rate of the two groups were compared between prenCPAP and postnCPAP at 2 h, 24 h and 48 h.
〖HTH〗〖WTHZ〗Results〖HTSS〗A total of 108 cases(93.1%) were successfully treated with nCPAP. Eight cases (6.9%) in the unsuccessful group were changed to treat by airway intubation and mechanical ventilation. PaO2, PaO2/FiO2 prenCPAP were lower，and PaCO2 were higher in nCPAP unsuccessful group(P＜0.05). After nCPAP treatment, breath and heart rate, PaCO2 of the children in the successful group were significantly decreased(P＜0.05). PaO2, PaO2/FiO2 were significantly increased(P＜0.05). All children had good tolerance to nCPAP and no adverse events occurred.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗nCPAP treatment has significant efficacy and high safety, and can effectively improve oxygenation and relieve hypercapnia in children. However, for children with severe hypoxia and obvious carbon dioxide retention, invasive ventilation should be selected as soon as possible.

Key words: bronchiolitis, continuous positive airway pressure, infant

贾系群，张中馥，郝改领，徐丽娟，李清华，马海民. 经鼻持续正压通气治疗中-重度毛细支气管炎的临床研究[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2019.09.004.

JIA Xiqun, ZHANG Zhongfu, HAO Gailing, XU Lijuan, LI Qinghua, MA Haimin . Clinical medical research of nasal continuous positive airway pressure in moderate to severe capillary bronchitis[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2019.09.004.

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经鼻持续正压通气治疗中-重度毛细支气管炎的临床研究

Clinical medical research of nasal continuous positive airway pressure in moderate to severe capillary bronchitis

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