河北医科大学学报

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经鼻持续正压通气优先策略治疗婴幼儿重症肺炎的临床效果观察

  

  1. 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:2019-04-25 发布日期:2019-04-22
  • 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 effect of nasal continuous positive airway pressure for preemptive ventilatory support strategy on severe pneumonia in infants#br#

  1. Department of Emergency, Affiliated Hebei Children′s Hospital of Hebei Medical University, Shijiazhuang 050031, China
  • Online:2019-04-25 Published:2019-04-22

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)优先策略治疗婴幼儿重症肺炎的临床效果。
〖HTH〗方法〖HTSS〗〖KG*2〗选择婴幼儿重症肺炎患儿70例,按照随机分组原则分为对照组和nCPAP组各35例,对照组采用普通面罩吸氧,nCPAP组采用nCPAP优先策略治疗。比较2组治疗前和治疗后2 h、24 h、48 h的动脉血氧分压(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)等指标,呼吸困难缓解时间以及气管插管率。
〖HTH〗结果〖HTSS〗〖KG*2〗nCPAP组呼吸困难缓解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)。治疗后,2组 PaO2、PaO2/FiO2呈逐渐升高趋势,PaCO2呈逐渐降低趋势,nCPAP组PaO2、PaO2/FiO2高于对照组,PaCO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)。
〖HTH〗结论〖HTSS〗〖KG*2〗应用nCPAP优先策略治疗婴幼儿重症肺炎效果显著,可阻止病情进展,减少气管插管率,是一种值得推广的无创呼吸支持技术。

关键词: 肺炎, 持续气道正压通气, 婴幼儿

Abstract: [Abstract]〓Objective〖HTSS〗〓To analyze the clinical effect of nasal continuous positive airway pressure(nCPAP) for prior ventilatory support strategy on severe pneumonia in infants.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Seventy cases of severe pneumonia were randomly divided into control group and nCPAP treatment group,and each group with 35 cases. The control group was received oxygen with ordinary mask, while the nCPAP group received nCPAP prior treatment.Compared with two groups of treatment effect, partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2), PaO2/fraction of inspiration O2(FiO2) were compared before and after treatment 2h,24h,48h. The time of breathing difficulty relief and the rate of endotracheal intubation were compared too.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The time of breathing difficulty relief was shortened,the rate of endotracheal intubation was reduced in nCPAP group, compared with control group. The differences were statistically significant(P<005). After treatment, PaO2 and PaO2/FiO2 in two groups increased gradually, PaCO2 decreased gradually, PaO2 and PaO2/FiO2 in nCPAP group were higher than those in control group, PaCO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).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The application of nCPAP priority strategy in the treatment of Infantile Severe Pneumonia is effective. It can prevent the progress of the disease, reduce the rate of tracheal intubation. It is a noninvasive breathing support technology worth promoting.

Key words: pneumonia, continuous positive airway pressure, infants