无创正压通气治疗小儿重症肺炎并心力衰竭的疗效

Noninvasive Positive Pressure Ventilation for the Treatment of Community-Acquired Pneumonia in Children with Heart Failure

目的探讨无创正压通气(NPPV)对小儿重症肺炎并心力衰竭(简称心衰)的治疗效果。方法将68例小儿重症肺炎并心衰患儿按随机数字表法分为2组:对照组32例,采用抗感染、吸氧、利尿和扩血管等常规治疗;观察组36例,在对照组常规治疗的基础上加用NPPV治疗。对2组入院时及入院治疗24 h后PaO2及脑钠素(BNP)水平的变化进行比较。结果 2组入院时PaO2、BNP比较差异无统计学意义(P>0.05)。治疗24 h后,观察组PaO2、BNP分别为(10.85±2.08)kPa、(212.5±42.8)ng.L-1,对照组分别为(9.27±1.59)kPa、(396.7±36.6)ng.L-1,2组比较差异均有统计学意义(均P<0.05)。结论 NPPV对小儿重症肺炎并心衰有较好的治疗效果,可迅速提高动脉血氧含量,改善心功能。

Objective To study the effect of noninvasive positive pressure ventilation（NPPV） on community-acquired pneumonia in children with heart failure.Methods A total of 68 children with community-acquired pneumonia and heart failure were randomly divided into two groups.The observation group（n=36） were given a combination of NPPV treatment and conventional treatment（anti inflammatory,oxygen uptake,diuresis and vasodilatation）,and the control group（n=32） received conventional therapy only.Blood gas analysis and brain natriuretic peptide（BNP） concentrations between the two groups were compared after treatment for 24 hours.Results Compared with the control group,PaO2 levels increased and BNP concentrations decreased in observation group [（10.85±2.08） kPa vs（9.27±1.59） kPa and（212.5±42.8） ng·L-1vs（396.7±36.6） ng·L-1,respectively（all P〈0.05）].Conclusion NPPV can rapidly enhance the arterial oxygen content and improve cardiac function.Therefore,it has a better therapeutic effect for community-acquired pneumonia in children with heart failure.