经鼻持续气道正压通气治疗婴幼儿重症肺炎35例

Nasal continuous positive airway pressure(NCPAP)treatment on 35 cases of infantile pneumonia gravis

目的研究经鼻持续气道正压通气(NCPAP)对重症肺炎合并心力衰竭(简称心衰)及Ⅱ型呼吸衰竭(简称呼衰)婴幼儿心肺功能的支持作用。方法重症肺炎合并心衰、Ⅱ型呼衰患儿35例在综合治疗基础上予应用NCPAP,观察NCPAP应用前后患儿呼吸频率、心率、血压、动脉氧分压(PaO2)、氧合指数(PaO2/FiO2)、二氧化碳分压(PaCO2)。结果应用NCPAP2小时后,患儿平均呼吸频率、心率、血压、PaO2、PaO2/FiO2有明显改善(P<0.01);PaCO2略下降,但与应用NCPAP前无显著性差异(P>0.05)。结论NCPAP可提高合并心衰及呼衰患儿肺氧合功能及左心泵功能,且不加重高碳酸血症。

Objective To explore the nasal continuous positive airway pressure （NCPAP） therapy for infantile pneumonia gravis combined with heart failure and respiratory failure and the effects on cardiorespiratory function. Methods Using antiinfection, cardiotonic and diuretic therapy, vasoactive agent as the basic heteropathy, thirty-five cases of infantile pneumonia gravis combined with heart failure and respiratory failure secondary including twenty cases of congenital heart disease received NCPAP. The owerage of respiratory rate, heart rate, blood pressure, arterial oxygen （PaO2）, oxygenation index （PaO2/ FiO2） and carbon dioxide tension （PaCO2） was detected before and after NCPAP treatment in each infant. Results After two hours of NCPAP treatment, the respiratory rate, heart rate, blood pressure, oxygenation index （PaO2/FiO2） and carbon dioxide tension of the infants were better than those before NCPAP （P〈0.01）. PaCO2 decreased, but the effect did not reveal statistically significant difference （P〉0.05）. Conclusion NCPAP has a good efficacy for improving the oxygenation and left ventricular pumping function in infants with heart failure and respiratory failure secondary, and it can not aggravate hypercapnia.